1981, 04-28 Permit: 81A-4014 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
lll/ APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS r LEGAL DESCRIPTION - SEE ATTACHED
1. /� �:L7('Li ` //
LOT BLOCK B !VISION PARCEL .UMBETt/S 0 3 * * 1 8 0 0
* 1800 'CO2. OWNER PHONE
3.
AD ( szi--e;*-41---,,„ 8C-, If:ete: -N -474.c,)-6e , 1 8 0 0 6
ZIP Actual Set Backs in Feet * 0.n O
�✓ /. / /714 0X' .(. 7t A�f/ North (South East (West
CONT C OR PHONE'y' Y7 Size of Parcel Zone Classification 4 0 1 3
- d
4 A pK _ �'} ZIP Type Const. Occupancy Sprinklered 4—2 8—8 1
L�� 7C) / ijrL',1�-c7 Elves ❑No ❑ Req'd. = 6 4 7 9.
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 ONEW ❑ ALT. ❑ AD'N. 0 RPL. ❑ MVE.
7. OF El OTHER -
WORK ❑ BLD. ElPLMB. 1j]
-MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCR E RK y Enum. Dist. Location (Area) T
�B ` , c : FEES COLLECTED
VALUATION SOURCE ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public 0 Private ❑
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 7- /'✓ — cT SIGNATURE OF APPLIC• 'i�- -.A Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE /T � /! Plan Check
Env. Health • !l..i i z.('
SEPA a—
G{ r>
Planning 1f_t4�Y- _ I — c)
Liy
—
�_ Mobile Home -�
LU
Fire Marshall � k / ,( 1.
Co. Engineer f Other(Specify)
Utilities /P4r'7
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
B ing chniccii'an PERMIT IS NONTRANSFERABLE O '4^H-`2a&±j:'..'Slrl�
' 4 O 1,4'z *I&0.0 a h
eJ 7 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL