1981, 02-17 Permit: 81A-1557 FurnacePLAN NUMBER
I•
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 BLOCK
2. 2.
fUBDIVIS`I�
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/5
OWNER
3.
ADD ESS
�1 /D/to-
CO TRACTOR
ADDRESS
DESIGNER
5' ADDRESS
PHONE
PHONE
9.7-1,- 7087
ZIP
'94/2.06
PHONE
ZIP
Actual Set Backs in Feet
North (South East (West
Zone Classification
Occupancy Sprinklered
❑Ves 0No 0 Req'd.
Building Area in Sq. Ft.
Upper Floors • Garage Area Storage
Size 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
0 BLD.
O ALT.
O PLMB.
0 AD N. 0 RPL. 0 MVE.
S^l 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 WORK
s. 44.0Td2 it
VALUATION
9.
SOURCE
OF
UTILITIES
.�.t,t�,t itc-a cz ((00 006 ,(3 TU 1 -
GAS ELECTRIC I V/ATER
Enum. Dist.
Location (Area)
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(
a-' / 7— 81 SIGNATURE OF APPLICANT "
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engines
Utll'tie
Plans Examine
SEPA Check
Build
ng Tec/ nicia
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
S" gle $
Building
Plumbing
Mech.
Plan Check
SEPA
•
6,00
Mobile Home
Other (Specify)
6
TOTAL $ /Io
PERMIT NUMBER
zr/A— /.5-s 7
04* *1600
* 1600
* 160.06
A *Q0.0 8
1556��'
02-17-81
2'• 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0':21;111,717 8
DATE ISSUED PERMIT NO. TOTAL
155:75 *16.0020
r
0
U