1981, 03-19 Permit: 81A-2556 FurnaceNUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. D 's,
LEGAL DESCRIPTION — SEE ATTACHED
LOT' B K ISUBDivr5rONPARCEL NUMBER/S
2.
OWNER PHONE
ADDRESS
IP V i
Actual Set Backs in Feet
> �^
Plan Check
Q
{: J
North South East
West
CONTRACTOR a
H NE
Size of Parcel
Zone Classification
a _T- 11V C O
4.
ADDR SS
ZIP
Type Const.
Occupancy
Sprinklered
T❑Yes
❑No ElReq'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin, Basement
6.
Baths
No. Stories
No. Rooms
No. of Dwellings
TYPENo.
NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE,
7, OF❑OTHER
1-1 BLD. ElPLMB. MECH. 1:1M.H. ❑POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORKD Q,
Enum. Dist.
Location (Area)
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
UTILOITIES
Public ❑Private ❑
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Building
to give authority to violate or cancel the provisions of any other state or local law regulating c nstruction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT ONS
Plumbing
DATE OF APPLICATION SIGNATURE OF APPLICANT
Mech.
SPECIAL APPROVALS
NAME DATE
nv. Health
Planning
Fire Marshall
o. Engineer
ns Examiner
SPECIAL CONDITIONS:
/J
Plan Check
Q
SEPA
l
Mobile Home
y
Other (Specify) -
n PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
TOTAL $
PERMIT NUMBER
04* *100
* 1 u: 0 0 r,
*1B00�
A *000 cc
255.5,E
03-19-81
6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 5i,191'-8'1 2 5 5.6 5,
DATE ISSUED PERMIT NO.
*18.00aP _
TOTAL