1981, 03-09 Permit: 81A-2166 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
friSPOKANE COUNTY — BUILDING CODES DEPARTMENT 7,LA- - �� 64,
Q..) NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED 0 4 * * 1 7.0 0
1.
E ((/ r 1 //�/
LOT BLOCK` SUBDIVISION PARCEL NUMBER/S * 1 7. 0 0 rn
2 OWNER PHONE * 1 7 0 u
3. J O H N 6 L/ /V /l/ 5-3 9 -,/"1'J A * 0 0 0
ADDRESS ,.L ZIP Actual Set Backs in Feet 2 1 5
K f 6-
0 11 -
'V Ll�t 9 f ;€ c 6 North (South East 'West
CONTRACTOR tl / PHONE Size of Parcel Zone Classification 0 3-0 9-8 1
4. iYvRc. v /f. 4-AT 4/ 6- JJV-9P'7i"
ADDRESSh---/Y-7- ,?
_ ZIP Type Const. Occupancy Sprinklered g 6 4 7 9,
‘1,0 / � T N J /YTSra Q (s 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.
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
❑ NEW ❑ ALT. 0 AD'N. ❑ RPL. ❑ MVE.
7. OF 0 OTHER
WORK CIBLD. ElPLMB. Ir MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
'y sof EXEMPTION
DV.sCRIBE WORK a ;2 ez,,Ie -= cr � Enum. Dist. I Location (Area) FEES COLLECTED
8. 4....,,,,t,..4_447 r .3 y /= 7172G(...g-e •19/ 1
LUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
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 /s`' / SIGNATURE OF APPLICANT AO - (. / /' L./_ Mech. `
SPECIAL APPROVALS SPECIAL CONDITIONS: lit6 Plan Check
NAME DATE
Env. Health
SEPA -
Planning p
U
Mobile Home W
Fire Marshall -_I
Er.
Co. Engineer Other (Specify)
Utilities TOTAL $/ 7'C-9G>
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
7;.4ng Tec ician i PERMIT IS NONTRANSFERABLE ! s•
d,
0`3i `-81 216,62 *17,00a �.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL