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1981, 02-09 Permit: 81A-1279 FurnacePLAN •rQUMBE-R- APPLICATION/PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 sir APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES 1. 2. 3. JOB ADD; 7 d rit �f/ 3 O Lr%+e .�� LOT SUBDIVISION BLOCK LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S OWNER ADDRESS PHONE ZIP Actual Set Backs in Feet North (South CONTRACTOR RAC ;fit €, 4. ADDRESS DESIGNER PHONE East West Size of Parcel Zone Classification PHONE Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd_ Valuation Building Area in Sq. Ft. 5' ADDRESS ZIP Main Floor Upper Floors Garage Area 6. CHANGE OF USE FROM TO Area of Decks Finished Basement Storage Unfin. Basement TYPE 7. OF WORK ,..Ver NEW ❑ ALT. ❑ BLD. ❑ PLMB. ❑ AD'N. ❑ RPL. ❑ MVE. X-MECH. ❑ M.H. ❑ POOL ❑ OTHER No. Baths No. Stories No. Rooms No. of Dwellings DESCRIBE npRK/ L� S. �,,•�s" /.4 l it �/ GC417/G VALUATION 9. SOURCE- GAS OF UTILITIES ELECTRIC WATER CERTIFICATE of EXEMPTION Enum. Dist. I Location (Area) Req'd. Recd. Not Req'd. SEWER Ownership Public ❑ Private ❑ USE CODE 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 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 DATE OF APPLICATION,Z -T---,/ SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist mg g T+�V'' SIGNATURE OF APPLICANT ��6 •iLJ2 fG� SPECIAL CONDITIONS: PERMIT IS NONTRANSFERABLE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) .GSC TOTAL $ 1, M j.. PERMIT NUMBER - 04* *14.00 *14,00 *14.006 A *0.00 g 127.82 02-09-81 2 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 02x=09-81 127:92 *140.020 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL