1982, 01-07 Permit: 82A-103 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY -"6U%DING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
/ APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB DJtt �"/�e
L'�[�Yf '/•/B,LCO"C�•�C/`•,K SUBDI 5
LEGAL DESCRIPTION — SEE ATTACHED
.d" lAtedifte4Jen4
fl/ CTOR
5.
DESIGNER
PARCEL NUMBER/S
ZIP •
PHONE
ADDRESS
ZIP
Actual Set Backs in Feet
North (South East (West
,..5 Zone Classification
'`/ Occupancy Sprinklered
❑Ves ❑No 0 Req'd.
Building Area In Sq. Ft.
Upper Floors 1 Garage Area Storage
Ize of Parcel
Type Const.
Valuation
Main Floor
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
O BLD.
❑ ALT. �❑AD N. 0 RPL.
O PLMB. 16 MECH. 0 M.H.
0 OTHER
❑ POOL
D RIBS W K gelA sir_ (e
8.
ALUATION SOURCE / ELECTRIC JER SEWER
OF
9. UTILITIES
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
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 APPLICATIO
SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examine
SEPA Checkli
Iding T-chnician
/ 1•'
,/ I /'
/ 0 I/
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
04* *1600
* 1600 N
* 1600
A *Q00
'1022
0.1 -07-82
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
:._;8�24
DATE'IBSUED PERMIT NO. TOTAL
1,0.3'5 *160 0 a g
•