1981, 04-23 Permit: 81A-3844 Oil Burner PLAN NUMBER APPLICATION/PERMIT e}{4 PERMIT NUMBER I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT r !
e
/ NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
// APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOBDRESS
1. g j rC� 7`L LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
3. ow;w, xi:4, - 7 PHONE a crSG
AD SS �J ZIP Required Set Backs in Feet
73 /5- f .--���L/ y`%- ``�`p-- 7 7 aac)& North [SouthEast (West
CO RACTOR PHONE Size of Parcel Zone Classification
02--1,4-ee.... /e...-e-cze 53s-esei
4' AD ESS ZIP/�/, g Type Const. Occupancy Sprinklered
,eC7Z. 74 — 3C�—r/ 3GcTZ 9P G Oyes ❑No ❑ Req'd.
DESIGNER / / PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area Basement Area Garage Area Storage —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
,,..���� No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW lid'ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE L:Zeq'd. Recd. Not Req'd.
of EXEMPTION
D S IBE WORK
8 / �, _/ _� ``'&' � 4 7-� t /lf- , , FEES COLLECTED
VALUAT N �-'JL+f Sourrcc"e'7 GAS ELECTRICTWATER SEWER
'r^^"
of
9. Utilities
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
Plumbing
performance of construction.
DATE f-- 2'Z - &" SIGNATURE__A Mech. /LOC/
,
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
z
SEPA
Planning t..)
— y
2
Fire Marshall Mobile Home c/)
z
Co. Engineer Other (Specify)
Utilities
TOTAL a"da
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
n$ O W�.E MIT.
o J
SEPA Checklist ` THISU O ^,,�' 3 8 4 4 2 *16.0.0 R g
DATE/2 OFF
APPR! 1R ISSUANCE _