1982, 08-04 Permit: M82A-6768 FurnacePLAN NUMBER
JOB ADDRESS
1.
LOT
2.
BLOCK
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
SUB SION
LEGAL DESCRIPTION - SEE ATTACHED
OWNER�,�3 i" v @ -
ADDRF,SS� o
CONTRACTOR
PHONE
1,740
5.
ADDRESS
PHONE
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South East 'West
Size of Parcel Zone Classification
Type Const.
Valuation
Occupancy Sprinklered
Dyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZI P
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
'Q .NEW ❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE.
❑ BLD. ❑ PLMB.(VIECH. ❑ M.H. 0 POOL
D SCRIBE WORK
8. 0 Gt.)
VALUATION
9.
SOURCE I GAS
OF
UTILITIES
0 OTHER
ELECTRI
WATER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
ILocation (Area)
Ownership
Public 0 Private ❑
USE CODE
Req'd.
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
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
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
BuilSlir�cl'.Yt'ch i i. n
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
P
04* *14.00
*14.006
A *000
676.72
08-04-82
z 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08 -*04-82 676,82 *14002 _
PFRMIT FYPIRFS [)NF VFAR FROM [)ATF DF ISSUANCE fIATF 'SCI ILn
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