1982, 11-01 Permit: 82B-0475 Furnace PLAN NUMBER APPLICATION/PERMITR
PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 8Z13 04'7 S�
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAVJESS,RIPTION — SEE ATTACHED
LOT BLOCK S BDIVISION PARCEL NUMBER/S 0 4 * * 1 6 0 0
2. * 1 E_ 00
/Y
OWNE PHONE/
3. -✓. w)-r-rta,). .��U-. �.,-t , y2" -3 p 7 c7 7 ), * r 0 0 2
ADDRESS ZIP Actual Set Backs in Feet
Cri //2 I /9'r:Z., North 'SouthEast (West 4 ,a
CONTRACTOR PHONE Size of Parcel Zone Classification
4. p,
� ..c. ._.1) r.." . L, -/- 0 1 1 —0 1 —R 2
ADD ESS /� ^7 /y ZIP /C Type Const. Occupancy Sprinklered � 6,4 7 9,
. !d/5! �.L--t*c��-twv C 4F -a�.d 99r2v Oyes ❑No 0 Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. B by 4,6"F 6 2S-l M
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 0 NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7, OF 0 OTHER Req'd. Recd. Not Req'd.
WORK
0 BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE
of EXEMPTION
DE CRIBE WO•K Enum. Dist. I Location (Area) '
S
FEES COLLECTED
8. ,.. f / Ui ,L---2- c, I
VALUATION SOURC GA "--"f 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
/ f
DATE OF APPLICATION /7// SIGNATURE OF APPLICANT ��4i..0�A ' 1..4...! Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health 4 ��
l 1----Z)/ ,Le)----6 wl l S EPA F--�
Planning
r)
Mobile Home '
Fire Marshall ii
Co. Engineer Other(Specify)
Utilities / �y
TOTAL $ / L/
s O
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Bu .ing Te hnician PERMIT IS NONTRANSFERABLE V1:7''''0 1 8 2 4 7, 5 z *1 6. 0 0 a e
A :, lam. f / PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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