1982, 09-13 Permit: 82A-8165 FurnacePLAN NUMBER
APPLICATION/PERMITPERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
/ NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
v APPLICANT: COM LETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADORELEGAL DESCRIPTION — SEE ATTACHED
1. .,..
LOT I BLOCK ISUBDIVISION PARCEL NUMBER/S
2.
OWNER/PHONE
3. /y'It\�A :4 A 4,A - — ---A
AD RE55
ZIP
Actual Set Backs in Feet
�\( p�
f 4" o V
North South
East West
CO ACTO
ONE
Size of Parcel
Zone Classification
e
P
4' AD ESS r
Z
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
DESIGNER
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.
Baths
No. Stories
No. Rooms
No. of Dwelling
TYPENo.
NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
% WORK (((((( ❑"' BLD. C-1PLMB. �MECH. 1:1M.H. ElPOOL ❑OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd
of EXEMPTION
DESCRIBE WOR n
Enum. Dist.
Location (Area)
,Kj
8.
FEES COLLECTED
V LUA ION
SOURCES
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
UTILITIE
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 or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
DATE OF APPLICATION SIGNATURE OF APPLICANT 1f- �'- '"
Mech.
SPECIAL APPROVALSI SPECIAL CONDITIONS:
NAME DATE
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
V".Ving,;�!�,h nician PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ( X
U 1 4.00
*1400`
A
09-13-82
b, 4 7 9•
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. L Z
09_13-82 6
*1400°