1981, 10-12 Permit: 81B-565 Furnace PLAN NUMBER APPLICATION/PERMIT
PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT h iii.r
505
e_li., NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. IS 5/3 e . & N / 'LEGA'I� DESCRIPTION — SEE ATTACHED 4 * * 1 8.0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 a 0 0
�R
Z. OWN RziList �(/L .. )Q V PHONE r / * 18,006
3. A * 0. 00 8
AD ESS ,+�h/ 7.71-0(o Actual Set Backs in Feet
/ 3 .5 /. . I€. North 'South East 'West 5 6 4 2
CONTRAC OR PHONE Size of Parcel Zone Classification
4' A RES e ZI � Type Const. Occupancy Sprinklered z 6.4 7 9
wIr"Y W
DYes ❑No ❑ Req'd.
DE IGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE
❑ NEW ❑ ALT. ❑ AD'N. X RPL. ❑ MVE.
7. ing• OTHER -
WORK CI BLD. ❑ PLMB. MECH. D M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
ISCRIBE WOR+( Enum. Dist. Location (Area)
8. ( t I / 4. I FEES COLLECTED
VALUATION SOURCE G S ELECTRIC ATER SEWERUSE CODE
Ownership
OF
9. UTILITIES 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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
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 Plumbing
DATE OF APPLICATION' SIGNATURE OF APPLICANT " '�SL.k„) Mech. 11"42
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE A10 G , ✓O Plan Check
Env. Health //-•s/. (�/ ? c
Q
i
—� SEPA o..
� �/T 7 ,<7 cP r/
Planning ` y O
� 1 /J - c... — w
Fire Marshall Mobile Home .-4
u.
Co. Engineer Other (Specify)--
Utilities e,�'�
TOTAL $ 4` —
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Bu.t ., •echni iar) PERMIT IS NONTRANSFERABLE ''' 8'l' 5 6,5 z * 1 8. d -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
4