1981, 02-04 Permit: 81A-1172 Furnace, FireplacePLAN 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 "]A 'HA
1. L 7 BLOCK -V ISBN
LOT I BLOCK FSB I nn 9
2.
LEGAL DESCRIPTION — SEE ATTACHED
3. Abo�� )iI
ilh1.tt
F, 79D 3 ‘444.04,d,
C NTRA TO0.4-144.74(./4-1
Ryy. 44 7
4.
PHONE
9-3.2//
PARCEL NUMBER/S Q 76-43-0843
S, .36' O,c RA el I IF ,t. / SO
13,1K 7 ssNrA ResA PARK
ZIP
99t -la
Actual Set Backs In Feet _
North !South
East
(West
PHONE
9;26-9a-2,43
Size of Parcel
Zone Classification
TDDRESS
, /e2 // 3 � xY pAa4 a
D SIGNER
5' ADDRESS
ZIP
994? -4%
PHONE
Type Const.
Occupancy
Sprinklered
Dyes ONo 0 Req'd.
Valuation
/ o20d7d0
Building Area In Sq. Ft.
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
❑ NEW
D BLD.
❑ ALT.
❑ PLMB.
0 AD N.
I MECH.
D RPL.
O M.H.
❑ MVE.
D POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
n ESCRIBE WO K -�
S.f D.r i t?p E.C. �A.Lt [�
OU SOlJO FCE
UTILITIES
VALUATI N
/aaa
GAS
Enum. Dist.
Ownership
Public 0 Private 0
Location (Area)
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 f a permit does not presume
to give authority to violate or cancel the provisions of any other state or local I r gulating constr Ion or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT NS
DATE OF APPLICATION r2`7—(V SIGNATURE OF APPLICA
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bul dingTech91c41,
cia
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ 3'1
Ov
PERMIT NUMBER
04.* - *34.00
*34.00 V)
1 1 7;1,2
02-04-8,1
2 61479.
e��D 00
aro 00
OU
05cr /4—
) oO
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'0 2,:. 0i'4{ ,8.,11
DATE ISSUED
117.22
PERMIT NO.
k3'40.Oa1
TOTAL