1985, 09-16 Permit: 00007579 Furnace PLAN NUMBER
/2- PERMIT NUMBE
APPLICATION/PERMIT 167
A 5 SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. EAST 1072 - 22nd. AVENUE LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDI ISION PARCEL NUMBER/S ze5.1— 1$
2. F 20 kwc `roc s E ]_
OWNER PHONE
3. LENORE CORDER
ADDRESS ZIP Actual Set Backs in Feet
Ea4t 10720 - 22nd . Avenue 99706 North (South East (West
CONTRACTOR PHONE Size of Parcel Zone Classification
4 POLDERS, INCORPORATED 535-7714
ADDRESS ZIP Type Const. Occupancy Sprinklered
FaAt 6507 Ma.e.2an Avenue 992 1 ? ❑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.
No.Baths No. Stories No. Rooms No. of Dwellings
TYPE ❑ NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7, OF 0 OTHER CERTIFICATE Req'd. Rec'd. Not Req'd.
WORK ❑ BLD. 0 PLMB. 0 MECH. 0 M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORKDist
.
1 ea. S8SS-1 OO1I 18C Cahntien Cfa4) Enum. I Location (Area) FEES COLLECTED
8. Chane nl t AtoraVVrrYyr� - 4" Int .intoe .LNtAn�r o .Lmn'rd I
VALUATION SOURCE I GAS ELECTRIC WAT SEWER Ownership USE CODE
OF
LI I Public 0 Private 0
9. UTILITIES
� / 1 \ 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 §tate or local law regulating construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION 9/ 16/R; SIGNATURE OF APPLICANT Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE ' /3N - Plan Check _
Env. Health
SEPA >-
Planning O
Mobile Home W
Fire Marshall L_
J
PeAMit
Co. engineer Other(Specify) 20 . 00
Utilities
TOTAL $ 20 . 00
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
FPA Checklist THIS BECOMES A PERMIT.
•
Building Technician PERMIT IS NONTRANSFERABLE —
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL