1983, 11-08 Permit: 83B-1421 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
14-•
SPOKANE COUNTY — BUILDING CODES DEPARTMENT � zl
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. South 1205 Skipworth i LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
OWNER PHONE
3, K. T. 13ERGMAN
ADDRESS ZIP Actual Set Backs in Feet rj 4 * * 1 6 00
S . 1 2 0 5 Skipwo th Road 99206 North (SouthEast (West
CONTRACTOR PHONE Size of Parcel Zone Classification * 1 C. 0 0 6
a. Powexs, Incoi poxaued 535-7714 , A * 0 c 0 E.
ADDRESS ZIP Type Const. Occupancy Sprinklered
E . 6507 Ma 2eovi; Avenue 99212 ❑Yes ❑No ❑ Req'd. i t( 2 0 .7
DESIGNER PHONE Valuation Building Area in Sq. Ft.
1 0 E
5' ADDRESS ZIP Main Floor Upper Floors Garage Area Storage
6 479. _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPE No. Baths No. Stories No. Rooms No. of Dwellings
❑ NEW ❑ ALT. 5a AD'N. ❑ RPL. 0 MVE.
7. OF 0 OTHER -
WORK
0 BLD. 0 PLMB. Di MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area) FEES COLLECTED
8. Change out qa.s Au tnace - Canx-ex 58GS-75
VALUATION SOURCE GAS ELECTRIC WATER SEWER
OF Ownership USE CODE
9. UTILITIES Public 0 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 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 REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION 1 1 / 3/R 3 SIGNATURE OF APPLICANT Mech. 6 . 00
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE X! Plan Check
Env. Health 75 , M13TU
�? nJ vent SEPA o`
4
Planning
8x8 TiZe Chimney
Mobile Home
Fire Marshall
t_a
_ rt
,
Co. Engineer -
2 0 1 gays p�p Othern(pecify) 10 . 00
Utilities
TOTAL $ 16 . 00
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
(din ch 'clan PERMIT IS NONTRANSFERABLE 1 1 -0 8 -'8'3 14 2;1 z. * 16, a -
�� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL