1981, 07-01 Permit: 81A-6588 Furnace, Heat PumpNUMBER APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
It PERMIT NUMBER
DATE
v APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
`
JOB ADDRESS .
LEGAL DESCRIPTION — SEE ATTACHED
1
LO BLOC SUBDIVISION
ARCEL NUMBER/S
2.
�4;-.
OWER PHONE
2
g *'
3.
in
` n _
ADDRESS ZIP
Required Set Backs in Feet
North South
East West
^
C NTRACTOR , PHONE
Size of Parcel
Zone Classification
r.
-. , 6 ••
6,ZIP
DRES
Type Const.
Occupancy
Sprinklered
L!Z
[]Yes ❑No ❑ Req'd.
DESIGNER PHONE
Valuation
Building Area in Sq. Ft.
5'
—
ADDRESS ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
��/
TYPE .✓�I NEW ❑ALT. El AD'N. El RPL. 1:1 MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF
❑ OTHER
CERTIFICATE
eq'd.
Recd.
Not Req'd.
❑ BLD. ❑ PLMB. �MECH: ❑ M. H. ❑ POOL
WORK
of EXEMPTION
DESCRIBE WORK
8
�
FEES COLLECTED
VALU ION S rce GAS
ELECTRIC WA R SEWER
of
9. Utilities
Single $
I hereby certify that I have read and examined this application
and have read the "NOTICE" provisions i
Ide
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governBuilding
type of work will be complied with whether specified herein or not. The granting of a permit does not
to give authority to violate or cancel the provisions of
any other state or local law regulating constructio
performance of construction.
Plumbing
DAT �/ � IQ(
SIGNATURE -fid
Mech. !
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Mobile Home
�
Co. Engineer
Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist
/
!
THIS B COM 1} 1S:APERMIT.
0 '-"Im-"1ry+ 1
658.0 Q z *2400aF-
DATE OF ICIAL
_