1981, 10-05 Permit: 81B-241 Furnace PLAN N, 1REF APPLICATION/PERMIT
PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT IV)
i8 � �
ijNORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. (6 3 ,I, \ S.
LEGAL DESCRIPTION - SEE ATTACHED .,) 4 * * 1 4.0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 4.0 0 tj
2 OWNS PHONE * 1 4'0 0 6
s. \`�`' A * 000
ADDRl Z(J; Actual Set Backs in Feet
� ( yo/ / ,1 y North [South East (West 2`.0 2
CONTR,���,CTO,^R y PHONE Size of Parcel Zone Classification 1 0-0 5-8 1
4' ADDR^ ^ zw Type Const. Occupancy Sprinklered 2
,, 7� ! /044 Co ❑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.
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
NEW ❑ ALT. 0 AD'N. 0 RPL. ❑ MVE.
7. OF �/ 0 OTHER
WORK 0 BLD. 0 PLMB. I�fNECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORKEnum. Dist. Location (Area) r
8. 1 c• d . , I FEES COLLECTED
VALUATI ZN SOURCE GAS ELECTP WATER SEWER
OF v Ownership USE CODE
9. UTILITIES �[ Public ❑Private 0
A 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
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS/a J
r e!" Plumbing /y�
DATE OF APPLICATION / SIGNATURE OF APPLICANT t'-�/�.A.A./ Mech. `f `t
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA }
a
Planning O
C.>
Fire Marshall Mobile Home
W
Co. Engineer Other(Specify) '
Utilities t 3i -{,
TOTAL $ 1/I°
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building Technician, . PERMIT IS NONTRANSFERABLE �i ',y'l i '� ' o O J -
f� c(_,. -/-7-7 � '�S;U 8 1� Z 41 z * 1 4,0 TOTAL
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL