1981, 09-15 Permit: 81A-9347 FurnacePLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
f NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-30675
V APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES,
OB
OPIES,
oe ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
LO . BLO S BDI ISION PARCEL NUMBER/S
2.
OW E,R P NE
3.
(ADJDRESSS/�
\r
ZIP
Actual Set Backs in Feet
7/^�
North South East
West
NTRACTOR
PH NE
Size of Parcel
Zone Classification
ADDRE�SjS�% /
ZIP-, -.
Type Const.
Occupancy
Sprinklered
)- •�t1 /� .tS, t
❑Yes []No ❑ Req'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
s.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
TYPE ❑ NEW ❑ ALT. ❑ AD' ❑ RPL. ❑ MVE.
], OF ❑OTHER
1:1 BLD. ❑ PLMB. MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
I
D RIBE WORK -4Z -
Enum. Dist.
Location (Area)
FEES COLLECTED
8.
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
UTILITIES
Public ❑ Private ❑
Single $
1 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 construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
"ATE � �
Mech.
OF APPLICATION A/ylefll SIGNATURE OF APPLICANT
SPECIAL APPROVALS
SPECIAL CONDITIONS:
I
NOME r)ATF
Plan Check
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
� Buildi ech an
PERMIT IS NONTRANSFERABLE
SEPA
Mobile Home
Other (Specify) /
TOTAL $ ! ,Z .
WHEN MACHINE VALIDATED IN TH
THIS BECOMES A PERMIT.
5 X81
04* *1700
*17.00 v
* 1 7.00
A *0.00 Cc) or
934.6`
09-15-81
6479.
DACE,
93 47 z
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