1981, 10-02 Permit: 81B-0190 FurnacePLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
`1-1 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK SUBD VISI N I PARCEL NUMBER/S
OWNER� ^.� �
r
PHONE
3.
Other (Specify)
A0,
TOTAL $
ADDRESS
q
ZIP
Actual Set Backs in Feet
WHEN MACHINE VALIDATED IN THI
sa r 1r
THIS BECOMES A PERMIT.
North South
East West
CONTRAC R
PH N
Size of Parcel
Zone Classification
4.
ADDRESS���� �
Type Const.
Occupancy
klered
Sprin❑Yes
, �V r
❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage Area
Storage
CHANGE /O OF USE FROM
TO 603Area
of Decks
Finished Basement
Unfin. Basement
6. �
TYPE �/'
❑ NEW ErALT. ❑OF A,�D��N. 1:1 RPL. El MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwelling.
7 -IC�ECH. ❑ M.H. ❑ pp ❑OTHER
El BLD. El PLMB. EP
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DF.-,QRIBE WORK
Enum. Dist.
Location (Area)
8• �`J J '�
FEES COLLECTED
VALUATION SOURCE
GAS
ELECTRIC
WATE SE R
Ownership
USE CODE
OF
9. UTILITIES
Public ❑Private ❑
Single $
1 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 o the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION
Plumbing
DATE OF APPLICATION SIGNATURE OF APPLICANT
Mech. f—=
SPECIAL APPROVALS
NAME DATE
iv. Health
anning
re Marshall
i. Engineer
tilities
ans Examiner
=PA Checklist
nifan I _
SPECIAL CONDITIONS:
FOR GAS APPLIANCES
PIPE SIZES W
PIPE LENGTHS Z.O
BTUS %Dc) j 0 0 0
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
C^
Mobile Home
Z
Other (Specify)
A0,
TOTAL $
1_
WHEN MACHINE VALIDATED IN THI
THIS BECOMES A PERMIT.
PERMIT NUMBER
t 0)
0q.* *18-00
* 1 8.0061
A *00
18,92
10-0c^-81
6,79.
E,
I Q n Q *1'AnnO-