1982, 10-15 Permit: 82A-9642 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
2.
3.
4.
5.
JOB ADDRSSSS
OCK SUBDIVISION
LOT
OWNE
ADD
CO
B
123
- • / 7/ 4u -
DESIGNER
PHONE
2ggar6
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
'.A
PARCEL NaIMBER/S
Actual Set Backs in Feet
North 'South
Size of Parcel
Type Con
Valuation
Occupancy
East
'West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basement
TYPE
7. OF
WORK
DESC RI
8.
VALUAT
❑ NEW
❑ BLD.
E WORK
•
❑ ALT.
❑ PLMB.
0 AO N.
MECH.
❑ RPL.
❑ M.H.
❑ MVE.
0 OTHER
0 POOL
SOURCE
OF
9. (UTILITIES
ELECTRIC
WATER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
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
SIGNATURE OF APPLICANT CIefillett
Req'd.
SPECIAL APPROVALS SPECIAL CONDITIONS:
Env. Health
Planning
NAME DATE
V.&
OIL /'^/ ,t1J/�
. Fire Marsh
Co. Engineer
Utilities
Plans Examine
SEPA Checkl
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Recd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
o 0
TOTAL $ /-'DLJ
PERMIT NUMBER
- %2"--
04* *14.00
*14006
A *000,8
96412
10=15-82
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
9'6'426 *14011.2.1-2,
PERMIT NO. TOTAL