1983, 02-24 Permit: 83A-1295 FurnacePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. ADDRESS
_S. la7rfi LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK rt3DIVlblUN PARCEL NUMBER/S
2.
OWNER PHONE
3. 3'AC K L , t .�'3. � - g
ADDRESS
ZIP
Actual Set Backs in Feet
�// �j
E", 3/
Jo�/i/�fy
North South East
West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
r1OrKSPAC #6161 A; ALa =
a8-0960
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
y�
M)jwsrls-
Yqpa 4
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.
TYPE NEW ALT. ❑ AD -N. ❑ RPL. ❑ MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
7, OF ❑ OTHER
❑ BLD. ❑ PLMB. X MECH. ❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
8• 6-4) r / 5 ST w 3 Gc) ELE'GT is f'
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
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 or the
performance of construction. REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
JSEE
�1
DATE OF APPLICATION/ %/ / %�J� _ SIGNATURE OF APPI ICANT/uC� //V/,
Mech. �/
SPECIAL APPROVALS
NAME DATE
Env. Hearin
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SPECIAL CONDITIONS:
I` 4-� 'V /o, azo
F'44 c +
-#/y.So
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
1A ;zA1'
9q5 1
TOTAL $ 6 � I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0�2�24�-8`3 129.5'7
* 1'4