1981, 08-24 Permit: 81A-8461 Furnace, Water Heater PLAN NUMBER APPLICATION/PERMITPERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT C� S g '
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS 04 * * 19,00
�� /� a_ - .,._ LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
* 1 9.00
2. * 1 9.006
OWNER PHONE
3. -4/ 00, .6 oet/jet .tii,,� Pal- ,'f/s A *0.0 0
ADDRESS ZIPActualActual Set Backs in Feet
4 6 y'/y /L? Ti / G,/e,s. e� '-' i9o7o6 North 'South East (West 8 0
CONTRACTOR PHONE Size of Parcel Zone Classification 0 8—2 4—8 1
A/AI QI,.,i--/' (v yr- f f/. y ---. /acs
4' ADDRESS ZIP Type Const. Occupancy Sprinklered z 6 4 7 9,
❑Yes ❑No 0 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.
No.Baths No. Stories No. Rooms No. of Dwellings
TYPE ❑ NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF 0 OTHER
WORK ElBLD. 0 PLMB. ❑ MECH. ❑ M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK ! Enum. Dist. I Location (Area)
8. ti� a rru� r / /0� fjifx FEES COLLECTED
A I/ �py�r/t i w �4 Kik G� ! f✓s1 ��k� I
VALUATION 5 URCE 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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
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 g"-,)-d -5r/ SIGNATURE OF APPLICANT G ,� - Mech. _Al'ee)
SPECIAL APPROVALS SPECIAL CONDITIONS: / 4.1-47.1Pas 57.ap
NAME DATE .� Plan(;heck
Env. Health S v f---k /e. / ,�iy i, dt
il
/9,M Pati 7-1 e t, y r-,e SEPA o
L1 7 — r�'
Planning w
Mobile Home -i
Fire Marshall
Co. Engineer Other(Specify)
Utilities g
TOTAL $ f !: G)�
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
' '
in ion 6. 0 8 -2 4`-PERMIT IS NONTRANSFERABLE 8�1 8 4 6.1 z .*19.0 0 �° F -
�:`'c-- ��� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
l_i . .