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1981, 08-26 Permit: 81A-8570 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 LOT E R Sit; BLOdK LEGAL DESCRIPTION — SEE ATTACHED • • UBDIVISI 0 PARCEL-NUMBER/S OWNER DO Dov C. Ptziw ADDRESS PHONE E . 831C„ 1JO2-14 ZIP 9.q cr• Actual Set Backs in Feet I North 'South East . 'west 4. CONTRACTOR cSvtYVtE, PHONE Size of Parcel 1 Zone Classification ADDRESS x aME ZIP Type Const. Occupancy Sprinklered Dyes ❑No ❑.Req'd. 5. DESIGNER PHONE Valuation 1 Building Area in Sq. Ft. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage CHANGE OF USE FROM 6. TYPE 7. OF WORK TO Area of Decks Finished Basement Unf in., Basement fLl NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE. 0 BLD. 0 PLMB. I!7 MECH. 0 M.H. 0 POOL 0 OTHER No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Re 'd. Not Req'd. DESCRIBE WORK 8. I cOI UCO STs. Gos riAaNACC Enum. Dist. Location (Area) VALUATION 9. SOURCE OF UTILITIES GAS ELECTRIC WATER SEWER Ownership Public 0 Private 0 USE CODE I hereby certify that 1 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 APPLICATIONX '— a — -. SIGNATURE OF APPLICAN SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist Build • Technician SPECIAL CONDITIONS: PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single • $ Building Plumbing Mech. . ‘c.). GG Plan Check SEPA Mobile Home Other (Specify) TOTAL $ tto: Cr+ PERMIT NUMBER - 70 04* *1600 *1600 *16006 A *000 85692 0.8=26-81 2 6479 ei WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. ti 81547'4'0 DATE ISSUED .6 PERMIT Nz } 0.