1981, 10-06 Permit: 81B-327 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
1.
2.
3
JOB ADDRESS
en /!� . Yre4/ '-10.661/elly
LOT B •CK S BDIVISfON
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
Xc rr, A26/1
ADDRESS
PHONE
PARCEL NUMBER/S
ZIP
Actual Set Backs in Feet
North (South
East
'West
4.
CONN RR,ACTOR /
Teri p✓ ‘te. Id,it
PHONE •
Size of Parcel
Zone Classification
AD
732V ,( .4'r
ZIP
999.4/
Type Const.
Occupancy
Sprinklered
❑Yes ❑No, ❑ Req'd._.
5.
DESIGNER
PHONE
Valuation
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
Unfin. Basement
7.
TYPE
OF
WORK
❑ NEW
O BLD.
❑ ALT.
❑ PLMB.
❑ AO N. C].RPL.
264ECH. ❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DE.5,cRIBE WO,,RK �-
8.PiGZGo,t A cr
VAL ATION SOURCE GAS ELECTRIC l WATER
e& QS
OF
9. UTILITIES
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
DATE OF APPLICATION 7C—'sc pi/
SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co
Engineer
Utilities
Plans Examiner
SEPA Checklist
Build) ec
SPECIAL CONDITIONS:
/4./.5) 400 .ices- iui"ykGe
tL5 ti/ Nya,
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
. Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
OC
TOTAL $ /9
PERMITNUMBER
&t13 -0227
04* *1900
* 1900
* 19006
A *000
3262'
10-06-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
3Z7Z *18.00,.2
PERMIT NO. TOTAL