1982, 09-13 Permit: 82A-8171 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
JOB ADDRESS
1. ff// S, ,14fl w%M 0,e /70,e,97lfiGc' Ge49-
f LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3.
OWNER
07f. M6J ETTn,e
PHONE
PARCEL NUMBER/S
ADDRESS
2,1// .s. /va 2'- A,rN
ZIP
9%037
Actual Set Backs in Feet
North (South
East
'West
CONTRACTOR
B/tY/A( ie,!/JEW'A cc
4. ADDRESS
PHONE
hl/XL 7,t/t,
Size of Parcel Zone Classification
ZIP
ygZ02
Type Const.
Occupancy
Sprinklered
DYes ONo 0 Req'd.
5.
DESIGNER
PHONE
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
6.
TYPE 0 NEW
7. OF
WORK 0 BLD.
DESCRIBE WORK
B. /NS'TstG�-
VALUATION
9.
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
0 ALT.
0 PLMB.
0 AD N. JYR PL. 0 MVE.
%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.
Enum. Dist.
CltcT,eic /=uR,t%c6
Location (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
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 9 /g'" d�J/ SIGNATURE OF APPLICANT%�
' SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
GXA//4V a //4c=9z//
27 6--,Ccc/
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
- FEES COLLECTED
Single $
Building
Plumbing /,/
Mech. /VOD
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
62A--si?(
04* *1&00
*1&006
A *0.00 I;
817.0i
0913-82
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
019 'dl" 3!'=i812
DATE ISSUED
8'17�15 *114,000.17
0)
PERMIT NO. 41 TOTAL