1981, 03-09 Permit: 81A-2168 FurnaceAPPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
v APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
2 LEGAL DESCRIPTION —SEE ATTACHED
LOT I BLOCK IbUBDIVISION PARCEL NUMBER/S
OWNER L f
3. L2-%I-�'t
ADDRESS
OR
ONE
Actual Set Backs in Feet
North South East
ONE r 1 Size of Parcel Zone
4.
ADDRESS
ZI
6
Type Const.
Occupancy
Sprinklered
1 e 7,v
6
❑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
6.
�
No. Baths
No. Stories
No. Rooms
No. of Dwellin
TYPE ❑ NEW 9-A LT. ❑ AD'N. El RPL. [I MVE.
7, OF El
❑ BLD. ❑ PLMB. MECH. El M.H. ❑POOL
CERTIFICATE
Req'd.
Recd.
Not Req'
WORK
of EXEMPTION
SCRI WORKz D �coo
Enum. Dist.
Location (Area)
FEES COLLECTED
8 CJ`7`7
VALUATION SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
OF
9. UTILITIES
� Q��
Public El Private ❑
Single $
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 thisBuilding
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 INSPECTIO
Plumbing
��F!�rTJ
DT
DATE OF APPLICATION b � 9 �71 � SIGNATURE OF APPLJCAdtT""�`.ir
1—>Q_Mech.Of
1
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
ans Examiner
Idi�rhit�cian
// JJ � o -
AL CONDITIONS:
y
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ i60
PERMIT N111111
04* *18.00
§1v00
*18.00
A *C.0^
216,7
03-09-81
6.4 7 9,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
21 b. 8`5
� 18.,0,0 R _�4