1981, 09-29 Permit: 81A-9947 FurnacePLAN NUMBER - APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS H RD T7 MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION —SEE ATTR
LOT
BLOCKJSUBDIVI�IFION
PARCEL NUMBER/S
2.
OWN
N
3.
A ESS"Actual
Set Backs in Feet
North South
East We
CONTRACTOR ✓
PH9NE
Siz of Parcel
Zone Classification
4. gDRESS
ZIP
Type Const. TOccupancy
Sprinkle
[�
❑Yes ❑No q'd.
DESIGNER
PHONE
Valuation
Building Area in S
5'
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
torage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
unf Basement
6.
No. Baths No. Stories
No. Rooms of Dwellings
TYPE ❑NEW 1-1 ALT. ❑ AWN. ❑ RPL. ❑ MVE.
OF ❑ OTHER
❑ BLD. ❑ PLMB.1 MECH. ❑ M.H. ❑ POOL CERTIFICATE
Req'd11 . Rec of Req -d.
WORK
of EXEMPTION
SCRIBE WORK Enum. Dist. Location (Area)
CLLECTED
FEES
VALUATION SO RCEJ GAS ELECTRIC WATER , SEWER Ownership USE CODE
OF Public ❑ Private
IUTILITIES
Single $
hereby certify that I have read and examined this application and have read the "NOTICE" provisions inclw Ld
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing ;iis
Buildi
type of work will be complied with whether specified herein or not. The granting of a permit does not prey me
to give authority to violate or cancel the provisions of any other state or local law regulating construction c the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION
Plum g
DATE OF APPLICATION SIGNATURE OF APPLICANT -s.��e
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
PI Check
Env. Health �/ ` / _J / //
'
(�/
SEPA
E
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
$
TOTAL
Plans Examiner
WHEN MACHINE VALIDA
THIS BECOMES A PERMI'
SEPA Checklist
/Building ec ici G,
PERMIT IS NONTRANSFERABLE U yJ,—i[' y — 0 j
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
81 ik ' `P�'H� �
n_GQ_
6479,
LL .r * 0 0
Lo -
X4.1
TED IN THIS SPACE,
7.
9948Z .8.00101 1' -
PERMIT NO. TOTAL