1982, 02-10 Permit: 82A-940 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES — P
RESS HARD TO MAKE 3.COPIES
LEGAL DESCRIPTION — SEE ATTACHED
JOB ADDRESS y
Lo BLOCK SUBDIVISIONy
2.
OWNER I/
3. Nv/t./.r. /k '4✓SG/1-7
PHONE
va Vf0 7
PARCEL NUMBER/S
ADDRES
s7r✓', /y" --g-- yG--sF/
CONTRACTOR
ZIP
Actual Set Backs in Feet
North (South
East
'West
a. %A/U%Q6r-,i-/ I`y //Iy ff/2,: i
ADDRESS
/d 7/O /.tom-// 0... -1./a --
DESIGNER DESIGNER
5.
PHONE
9J8 -2/ao
Size of Parcel
Zone Classification
ZIP
9ya/a
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage.
6.
•
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE 0 NEW
7. OF
WORK 0 BLD.
O ALT.
❑ PLMB.
❑ AD N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
DESCRIBE WORK
8./.4-1.:44-// /%can. rawO.re. F/uF 74%Q /1/4t
VALUATION
9.
vn �'/
URCE
OF
UTILITIES
GAS
ELECTRIC
WATER
❑ OTHER
F/.e
No. Baths
Enum. Dist.
No. StoriesI
No. Rooms No. of Dwellings
Req'd. Recd. Not Req'd.
CERTIFICATE
of EXEMPTION
Location (Area)
SEWER
Ownership
Public DPrivate 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 3 — Y SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
//
�•1 PK,
i e Save
/lax , rc/1 ape'
P e/ 9ar
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. /O'dEf
Oi /z q, rid
Plan (heck
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
04* *19.00
* 19.00.
* 19.006
A *0.00
9392'
0'2-10-82
g 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0;'&15.'0H48121
DATE ISSUED i , PERMIT NO. - TOTAL
9402 *1'9,00,x1-
}
a
0
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