1981, 07-15 Permit: 81A-7030 FurnacePLAN 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 ADDRESS
1.
LOT
2.
BLOCK
%O4( /(Zc Ts 1.. ,.
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER
3 YWe),
ADDRESS QQ
�a C
CONTR/AC�/OR / ' —� // 7€4/ 4. yWA,/
ADDRESS—?7- - AS
PHONE
ZIP
Actual Set Backs in Feet
North (South East 'West
PHONE
?Zz < rical
Size of Parcel 1 Zone Classification
ZIP
9920/
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation (Building Area in Sq. Ft.
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 . ALT. 0 AD'N. 0 RPL. 0 MVE.
❑ BLD. 0 PLMB. aYMECH. 0 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 WO3K
8. �- - r � /• 49 //mac 4.r' .4u.�.K`cce
VALUATION SOURCE GAS
OF
9. UTILITIES
ELECTRIC I WATER
SEWER
Enum. Dist.
ILocation (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 7-Z3- 3- a / SIGNATURE OF APPLICANT(//b%
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building /p)chnician
Al 7.x.11., n
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
I4
PERMIT NUMBER
2A-7c�;'
04* * 1 4.00
* 14.00 3
* 1 4.006
A *0,00
702,9-2
07-15-81
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 7i -l. 5 8''1'
703,0 Z *1400 2-0