1981, 06-01 Permit: 81A-5299 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
1. JOB ADD
RESS
T elelJ/f
LOT SUB6IVI5I
2.
OWNER
3 /%// �ijL^.OS OtL/
ADDRESS .�
r. 9303 ,6reet-e �
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
PHONE
ZIP
Actual Set Backs in Feet
North 'South East (West
CONTRACT0
4 MSG /D- - Z 4-G✓ 74411117.d
ADDRESS/�
/f Z1/ , fN
5.
DESIGNER
PHONE
Size of Parcel 1 Zone Classification
9'z'
Type Const.
Occupancy Sprinklered
❑Yes ❑NO ❑ Req'd.
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE'
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
NEW
0 BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
Z MECH.
❑ RPL.
O M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
8.
9.
DESCRIBE WO K
2 r l //prof
VALUATIO SOURCE
OF
UTILITIES
o/Pc by/Pi 11-711ne. toPi
Enum. Dist.
Location (Area)
✓ GAS
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
SIGNATURE OF APPLICANT,044 ._c iO/Ik' Vit
DATE OF APPLICATION s=z9
SPEfIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examine
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
-Meth.
Plan Check
SEPA
Mobile Horne
Other (Specify)
OP_
TOTAL $ /y
PERMIT NUMBER
t i - 5297
04* *14,00
* 14,00 '
* 14006
A *000 S
529.88
0'6-01-81
g 6479.
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
„0;6p. Ip 1:7! !
DATE ISSUED
5.29.9: *_1.40.0
O J —
aF
PERMIT NO. TOTAL
0 -