1981, 10-06 Permit: 81B-319 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
C\)) APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. 1 /2- 5-4.), p 3>...Jtes e LEGAL DESCRIPTION — SEE ATTACHED 0 4 * * 1 4.0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 11 0 0 rn
2.
OWNER PHONE * 1 4.0 0 6
3. 4 41 4-/t?' -14,f j yac'-at&O A * 0 0 0
ADDRESSr / ZIP C Actual Set Backs in Feet
/— /01 5-07 r/ 5ct// s(' �C7e,, --- r g +7`/ 0 North 'SouthG'i East (West 3 1, 8 z
CONTRACTOR PHONE
PHONE Size of Parcel Zone Classification
1 - 62i �'L'�1-l' y f'/r. r r/PG /-,.-i, . '9;2 i- ?/"00 1 0—0 6—8 1
4. ADDRESS ZIP / Type Const. Occupancy Sprinklered o 6 4.7 9.
AS /9) I.
7 /O `,ev f LL---Lf' Jr ��/ •-ii"fit.- i' ?7,?/6Dyes ❑No 1=1 Req'd.
`
DESIGNER I 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 Unf in. Basement
6.
No.Baths No. Stories No. Rooms No. of Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE.
7. OF ❑ OTHER -
CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. 1=1 MECH. 1=1 M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area) '
8. s _ I FEES COLLECTED
`
/v f,-/ f<it f I�rri t'/t. Gv�.- o9 e75 Gly(-qtrµr' I
VALUATION SOURCE GAV ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public ❑Private 0
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
//�A i"_yam '` Mech. ICA GEl
DATE OF APPLICATION 4' S—5-/ SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS: Ge)
Plan Check
NAME DATE �+ `-i / ///JJJ
et
Env. Health ���l �� �L! �� N
SEPA n
Planningr_j
Mobile Home 1
Fire Marshall
W
Co. Engineer Other (Specify)
Utilities
TOTAL $ /4' G /
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Suildin .Te nici. PERMIT IS NONTRANSFERABLE 1.0,'40'61 R
'8 1' 31.9 z * 14.0 O.a -
i PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL