1982, 02-16 Permit: 82A-1072 FurnacePLAN NUMBER
1
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
1.
2.
3.
JOB ADDRESS
LOT SUBDIVISION
BLOCK
LE,r.AL DESCRIPTION - SEE ATTACHED
4
OWNEa>
9
PHONE
907C— f6e6 6
PARCEL NUMBER/S
ADDRESS
/./9/& z"
ZIP
Actual Set Backs in Feet
North !South
East
West
CONTR CTOR
4. ADDRF
7A- - 0P
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
❑ NEW
❑ BLD.
Ix ALT.
❑ PLMB.
AD'N.
0 MECH.
RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8244_,/..
ESCRpBE WORK
....f..4o.."4/
ORK//jj
ALUATION �t
//JJ
s./. -tea
SOUR E
OF
UTILITIES
GAS 1 ELECTRIC
WATE R
SEWER
Enum. Dist.
Ownersh ip
Public ❑ Private ❑
Location (Area)
USE CODE
I hereby certify that 1 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 constiction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Fngineer
Utihties
Plans Examiner
SEPA Checklist
BJ,{jldin1 TgchniciarC
SIGNATURE OF APPLI
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing -
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL OG
PERMIT NUMBER
— io"7 Z
04* *2200
*2200 U)
*2200'6
A *000 8
1 0 7, 1 2
02-16-82
2. 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
02•
;16-'82
DATE ISSUED
107.25 *22.002.
PERMIT NO.
TOT ...i