1982, 02-03 Permit: 82A-766 Furnace, PipingPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — WILDING 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
OWNER /`y/
f
BLOC
NoR�R / tf,, L.occQsf
K SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
3. 144/81-0A/J[ L/IV
/044 / lir /occas%
CONTRACTOR s
2CSonq-/7et1cp.
4. ADDRESS�� p
/Vo,e —4i 907 6 °ato &
DESIGNER -
ADDRESS
PHO 7i4
PARCEL NUMBER/S
7
5.
ZIP 99070(1
PHOCNNE
557.333
Actual Set Backs in Feet
North 'South
East
'West
Size of Parcel
Zone Classification
ZIP/ /GVW
Type Const.
Occupancy • Sprinklered
Dyes ❑No 0 Req'd.
PHONE'
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
I1�NEW 0 ALT.
0 BLD. 0 PLMB.
❑� ADS�N. 0 RPL.
IC' ECH. 0 M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
R-�i7St, // 4S
VALUATION RCE
OF
9. UTILITIES
Enum. Dist.
/'4/n. ' P'..w» Cr
Location (Area)
LE df RIC
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 cons -. or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS )
SIGNATURE OF APPLICA
DATE OF APPLICATIONJA
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examine
SEPA Check!
SPECIAL CONDITIONS: I bo, oOFJ t3iLA.
or%
4 tr...
545 rope
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA •
Mobile Home
6.ou
/0.6°
Other (Specify) dr
r"6.
TOTAL $ (!)r
00
PERMIT NUMBER
02A- '7&
04*
A
*1a00 joi
*11:00
*1aoo6
*0.00
765A
'021-03-'82
2 .6479.
55 e pr_r/n//
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0;2;2;0'!31: 8121 -7 6.61
DATE ISSUED PERMIT NO. TOTAL
*1'U 0,0dl,- -
›-
0-
0 0-
0
U
-J
LL