1981, 01-20 Permit: 81A-694 FurnaceNUMBER 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
LEGAL DESCRIPTION —SEE ATTACHED
LOT BLOCK SPARCEL NUMBER/S
2.
O NER PHONE
A�DDD�4RESS vZIP Actual Set Backs in Feet
uf�/
North South East West
CONTRACTOR r ,
IgRAI c' t Gr�Gi ice
PHONE
53 %//
/
Size of Parcel
Zone Classification
1 .4'',,VWX4 •
..�
4.
AD�D13ESS
ZIP
. ✓� j�C��i
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ElReq'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5. ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
TYPE ❑ NEW ALT. ❑ AD'N. RPL. ❑ MVE.
7, OFy� 10OTHER
El BLD. ElPLMB. ►N VIECH. ❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
.� ��
Enum. Dist. Location (Area)
FEES COLLECTED
VALUATION I SOURCE f GAS ELECTRIC I WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public EIPrivate ❑
Single $
1 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 Building
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 Plumbing
DATE OF APPLICATION � SIGNATURE OF APPLICANT �`'�� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: J feq 01,e�y7
NAME DATE F
lealth
Manning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
By{IAingne nic apn
`
/;.50 10A!
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
/)/ PERMIT NUMBER
- ��IA-6
4 *
* i C, ,
I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
69,49 *1Z00O� -