1981, 04-14 Permit: 81A-3542 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
LOT
BL 6K
/nag/ /Y! G/!, , i
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER ��
3. >1// S.-470 r() H/
ADDRESS d
9rdr 4',-'oa./�i tJP.f/
CONTRACTOR / J
4. "61:41/4,- 7079-4,14-1,!Gots tee/
ADDRESS
/J74' 4! .,✓f/'
DESIGNER
5.
PHONE
ZIP
Actual Set Backs in Feet
North 'South East (West
PHONE
Size of Parcel 1 Zone Classification
ZIP
fY2c/
Type Const.
Occupancy
Sprinklered
Oyes ONo 0 Req'd.
PHONE
Valuation (Building Area In Sq. Ft.
ADDRESS
1
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE acrNEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
7, OF
WORK 0 BLD. 0 PLMB. ..0..MECH. 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 WOR5,l / /
8.
e
Enum. Dist. I Location (Area)
VALUATION
9.
SOURCE GAS
OF
UTILITIES
ELECTRIC
WATER I SEWER
Ownership
Public D Private 0
USE CODE
I hereby certify that 1 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 y-Yy`�7✓ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health ,
Planning ,
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Lding
SPECIAL CONDITIONS:
1 �
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
86
TOTAL $
PERMIT NUMB€R
41s
04* *14.00
*14.00 63
*14.0.0(5
A '1,0.0.0 3
354.12
04-14-8:1
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0!4(� 11 i417111.1 1
DATE ISSUED PERMIT NO. TOTAL
3'542 , *1. 4.0 0,2.