1982, 12-17 Permit: 82B-1991 Furnace1' -
PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
2.
3.
JOB ADDRESS(
LOT
BLOCK
ADDR�SS
CONTRACTOR
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
SUBDIVISION
4.�.�.
ADD S 5_? )7
DESIGNER
5' ADDRESS
PHONE
Z
-/i 71)
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South
Size of Parcel
East
West
Zone Classification
Type Const.
Valuation
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
Main Floor I Upper Floors ` Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
DESCRIBE WORK
8. •._
VALUATION
9.
❑ ALT- ❑ AD'N. ❑ RPL. ❑ MVE.
❑ PLMB. "4/MECH. 0 M.H. 0 POOL
SOURCE
OF
UTILITIES
GAS
0 OTHER
2�l'Lf3--d--11_f
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public 0 Private 0
Location (Area)
USE CODE
I hereby certify that I have read and examined th'. application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true ,gnd correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified 4aerein or not. The ! ti g of a permit does not presume
to give authority to violate or cancel the provisions of any otter state or I. .w regul ing construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPE T ONS
DATE OF APPLICATION
SIGNATURE OF APPLI
Req'd.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B
c n�
I )c) Uzi o ` 4(s /J = - 0->
0 c;p
7.5-
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
;z2)_)
1:* *1E00
* 1 E 0 Q v
A *000
199.0 2
12,-17-82
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1'2-17-8.2.
DATE ISSUED
199.15
PERMIT NO.
*18,00
TOTAL