1982, 11-04 Permit: 82B-609 FurnacePLAN NUMBER
S3oo r. a APPLIfATION/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
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3
OW
ADDRESS
PHONE
ZIP
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South East (West
CONTR CTOR
4. AD R �i 44.
\.e t4
PHONE
Size of Parcel - 1 Zone Classification
ZIP
. Type Const.
Occupancy
Sprinklered
Dyes DNo 0 Req'd.
5.
DESIGNER
PHONE
Valuation I 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
O NEW
O BLD.
O ALT.
❑ PLMB.
O AD N.
O MECH.
❑ RPL.
O 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
8. CM
Enum. Dist.
Location (Area)
VALUATION
9.
SOUPRE
OW
UTILITIES
AS ELECTRIC
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 construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
" V
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marsha
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
/ e;doO /S"n>
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
PERMIT NUMBER
04* *1600
*16006
A *0.00,8
6'0.82
1
1-04-.82
2 '6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
BECOMES
41
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
.i
PERMIT IS NONTRANSFERABLE
605 x16,00-2�