1981, 06-01 Permit: 81A-5295 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
Acze, I!% G ; e
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
PARCEL NUMBER/5
OWNER
tet -/-r;
ADD ESS
CONTRA .T9• s. x//[%f- � /' �jj'
4. Z c -'l4✓ moi' , h& (
ADDRESS
/Jz ' il! AK -Xi
PHONE
ZIP
Actual Set Backs In Feet
North 'South East 'West
PHONE
nee 201
Size of Parcel 1 Zone Classification
5.
DESIGNER
ZIP
fXo/
PHONE
Type Const.
Occupancy
Sprinklered
DYes ONo 0 Redid.'
Valuation I Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfln. Basement
/v NEW
O BLD.
O ALT. 0 AD N. • 0 RPL. 0 MVE.
❑ PLMB. CMECH.- 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Redid.
Rec'd.
Not Req'd.
DESCRIBE WORK
VALUATION SOURCE GAS ELECT IC WATER I SEWER
OF
9. UTILITIES
Enum. Dist.
Location (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 S.' z/ -'c/ SIGNATURE OF APPLICANT 10
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Check% st
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing'
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
7
J®ee
TOTAL $ 1
PERMIT NUM.SER
g1A- -52-5y5
04* *1400
* 1400 1
* 14006
A *000
529.48
06-01-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•
529.51 k;1.400°a -12
DATE ISSUED PERMIT NO. TOTAL