1981, 05-04 Permit: 81A-4260 Furnace PLAN NI.BER APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT PERMIT NUMBER
�� NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
-'41" ADDRESS0 4 i, * 1 4. 0 0
1. Dy ,('��
LEGAL DESCRIPTION — SEE ATTACHED 1 G 0
—OT BLOCK SUBDIVISION PARCEL NUMBER/S
2. * 14. OpY
OWNER PHONEA * O 0 0 P,
/
3 ADDRESS // ✓ ZIP Actual Set Backs in Feet 4 2 5 9
North (South
CONTRACTOR East (West 0 5—0 4—8 1
aQ PHONE Size of Parcel Zone Classification
4.
ADDRESS
, (j / ZIP Type Const. Occupancy Sprinklered
,, /?� / if AJ19.z f ❑Yes ❑No ❑ 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.
TYPE No. Baths No. Stories No. Rooms No. of Dwellings
NEW D ALT. ❑ D'N. ❑ RPL. 0 MVE.
7. OF 0 OTHER
WORK 0 BLD. 0 PLMB. MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBERK W ✓ Enum. Dist.---27.T,-.4t ,F// mil 411 G �ifei �q e-A I Location (Area)
( FEES COLLECTED
8.
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public ❑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 3 /—r/ . i..,
SIGNATURE OF APPLICANT ` le /f- ' '��j Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
Planning SEPA 2
v
Fire Marshall Mobile Home "'
J
W
Co. Engineer Other(Specify)
Utilities
TOTAL
$ /4
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Bui g ianr PERMIT IS NONTRANSFERABLE h i..' o O _i -
1 015i 0` .4 g,1' 426, 05 *14000. 1-
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED 'PERMIT NO. TOTAL