1981, 08-03 Permit: 81A-7717 Furnace, Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
2.
5.
JOB ADDRESS
APPLICANT: COMPLET•E;TIUMBERED SPACES - PRESS HARD TO MAKE 3 -COPIES
LOT BLOCK SUBD VI
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OW
ADDR S�Q
CON ACTOR
DESIGNER f
ADDRESS
�1 Lt 2C+.%y
Actual Set Backs in Feet
North
Size of Parcel
Fla
PHONE
South
Type Const.
East West
Zone Classification
Occupancy Sprinklered
DYes DNo 0 Req'd.
Valuation Building Area in Sq. Ft.
CHANGE OF USE FROM
6.
TYPE
7. OF.
WORK
TO
ZIP
Main Floor
Upper Floors Garage Area
Area of Decks
Finished Basement
Storage
Unf in. Basement
NEW 0 ALT. D AD N. 0 RPL. 0 MVE.
0 BLD. 0 PLMB. ECH. D M.H. 0 POOL
9.
0 OTHER
79
DE$t RISE W RK (J D -� Q
y -- -- ri ,C Ac.-� a/ n -d c- 'r a .
O7{LUATION SOURCE GAS I ELECTRIC WATER SEWEPt-
OF
UTILITIES
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
Enum. Dist. I Location (Area)
Ownership
Public 0 Private 0
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local Ow regulating construction or the
performance of construction.JSEE REVERSEJSIDE FOR REQUIRED INSPECTIQNS
n/
DATE OF APPLICATION ! - /6 ^$ / SIGNATURE OF APPLICA
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
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 $
PERMI9-NUMBCR
thr-771;7
04* *1900
*19.00 t5
*19.00
A *000 3
77162
b8-03-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
!0,,8t
' �1r3H1:81.1. ' 7'i717 z *'19.010 a �.
DATE ISSUED PERMIT NO. TOTAL
›-
IA -
WHEN
LL