1982, 10-11 Permit: 82A-9370 Furnace, Heat PumpPLAN 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
JOB ADDR5E
1. 6
LOT BL CK
2. ' t"
3.
OWNER A
ADD{ ESS 4.6
4.
5.
A -1
AD!ESS
(P
DE NER
...16.)117VISION146'24>t
rAlc4
zi tt
(61- i l lc. cap. s‘.1.
S
LEGAL DESCRIPTION - SEE ATTACHED
PHONE
'26-527byo6
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South
East
West
k
PHONE
32- j3
PHONE
Size of Parcel
Zone Classification
Type Const.
Valuation
Occupancy
Sprinklered
Dees DNo 0 Req'd.
Building Area in Sq. Ft.
ADDRESS'
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
O BLD.
D ALT. 0PAN. 0 RPL. ❑ MVE.
❑ PLMB. 2/MECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. Lr-klkt(bkcr\rte) k ►4 ' fr
VALUATION SO RCE GAS ELECTRIC AThR 'EWER
OF
9. UTILITIES
Enum. Dist.
Location (Area)
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 INSPECTIONS
DATE OF APPLICATION /19 // � SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Healt
lanning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
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
$
PERMIT NUMBER
04* *19.00
*19.006
A *000
93692
1411-82
2 6479.
fPl
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1� 0.74“ 1,> sil
9"3'7105 id: 9,00.'a� -
7 DATE ISSUED PERMIT NO. TOTAL