1981, 06-23 Permit: 81A-6239 FurnacePLAN NUMBER e
PJ
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. E - 10434 RDLIVIRIUI
LOT BLOCK
2.
3
SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
En
LIWICunit
PHONE
cZ4-5 "7
PARCEL NUMBER/S
ADDRESS
E. i250'' ( + -&'DAOV`I
ZIP
Actual Set Backs In Feet
North 'South (East 'West
4.
CONTRACTOR
j\o i Ivr.
PHONE
‘2Z�770 7
Size of Varcel Zone Classification
ADDRESS
E . 104-oB
sTiA
P
Type Const.
Occupancy
Sprinklered
❑yes ❑No 0 Req'd.
5.
DESIGNER
PHONE
Valuation )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
7.
TYPE
OF '
WORK
dNEW
0 BLD.
❑ ALT. DJAD N. 0 RPL. 0 MVE.
❑ PLMB. LYl MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Storle
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. FLf'T2t(-
VALUATION
9.
FLtQe1r 12D K Lo'1 Melt Lt)oac
Enum. Dist. 'Location (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
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 INSPECTION
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL -APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu
Technician
Mar
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. 4.14, oo
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ Ict• CO
PERMIT NUMBER
at A- &7!-
04* *14.00
* 14.00 16
* 14.006
A *Q00
6.23.88
06-23-8;1
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
011��' i 2{,'3 -18
i'1� 6 2 31i 9'Z; *1410'0 a �.
DATE ISSUED .PERMIT NO. TOTAL
›-
0-
-J
0 -
J
LL