1981, 11-02 Permit: 81B-1370 FurnacePLAN NUMBER
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
2.
JOB ADDRESS
LOT 1 BLOCK (SUBDIVISION
.7 LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
3.
•
ADD SS
��/l..] /
010 i�(i(n
RACTOR
PHONE
ADDRESS
/o5 25
DESIGNER
5' ADDRESS
ZIP
PHONE
3'zy— Sfly
ZIP
PHONE
Actual Set Backslin Feet
North `South
Size of Parcel
Type Const.
Valuation
Occupancy
East
(West
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW 0 ALT.' ,❑�, ADSN. 0 RPL.
❑ BLD. 0 PLMB. MECH. ❑ M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
1
No. Rooms
No. of Dwellings
Req'd.
Rec'd.
Not Req'd.
8. VEIBE WORK ,/
S tE—>-L4,( f-4' 0.-7
Enum. Dist.
Location (Area)
VAL ATI
9.
SOURCE
OF
UTILITIES
GAS 1 ELECTRIC
v
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
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
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT ± S
dot
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marsha
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SIGNATURE OF APPLICA
SPECIAL. CONDITIONS:
i(/i010/ •r/`-"� t` 44R
%P-.5/ Uo 0 'gyre/ 4Z7n.--7- r
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech:
Plan Check
SEPA
Mobile Home
Other(Specify)
TOTAL
$ (17,09 -
PERMIT NUMBER
3113-1370
04* *17.00
* 17.00
* 17.006
A '*0:00 S
1369e
1:1-02-81
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
+h( ,0i2r—:.8i'l
DATE ISSUED
137.0,a *17,002. -
PERMIT NO.
TOTAL
2
O
U