1981, 11-05 Permit: 81B-1534 FurnacePLAN NUMBER APPLICATION/PERMIT�fy PERMIT NUMBER
SPOKANE COUNTY -- BUILDING CODES DEPARTMENT Y/(J�IJ 6 - 1*5
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
TYPE ❑ NEW
u APPLICANT: COMPLETE NUMBERED SPACES — PRESS
HARD TO MAKE 3 COPIES
JOB ADDRESS.
_
No. Stories
LEGAL DESCRIPTION — SEE ATTACHED
No. of Dwelling
�� ��/
El OTHER
LOT/
BLOCK
NUMBER/S
2.
❑POOL
ISUBDIVISIONARCEL
Req'd.
Recd.
Not Req'd
WORK
3
of EXEMPTION
I
DRE
ZIP
Actual Set Backs in Feet
Enum. Dist.
Location (Area)
FEES COLLECTED
North South East West
CTOR
PH9NE,
a of Parcel
Zone Classification
4.
*AS
G1 )
Type Const.
Occupancy
Sprinktered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5"
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USF FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
�C//
+Y
TYPE ❑ NEW
01
❑ ALT. ❑ AWN. ❑ RPL.
❑ MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
7, OFy/
El OTHER
F-1 BLD.
❑ PLMB. MECH. 11M.H.
❑POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
I
DESCRIBE,WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
VALUATION I SOURCE GAS ELECTRIC WATER SEWER
Ownership USE CODE
9. UTILOITIES Public ❑Private ❑
Single
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 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 REEfVERSE SIDE FOR REQUIRED INSPECTIONS /J_ ) Plumbing
DATE OF APPLICATION �/ �✓ SIGNATURE OF APPLICAN r �i?�j{i�r�,-z Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE t� fv� Plan Check
Env. Health
SEPA
Planning
Fire Marshall
neer
miner
ng Technician PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Mobile Home
Other (Specify)
TOTAL $
04* *1800
*1800
A *000
1 5 3,
1 1 -05-81
6,474
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1h -0°5._81, 153,45 *18,00 -�J- -
DATE ISSUED PERMIT NO. TOTAL