1981, 01-19 Permit: 81A-0610 Boiler PLAN NUMBER APPLICATION/PERMIT PER�rM�IT NUMBER S I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES * 2 1,0 0
f.
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED * 2 1.0 0
L T BLOCK SUBDIVISION PARCEL NUMBER/S * 2 1.0 0 cc.,
2.
/-� ^ n/� f1 *0,0 0 g
OWNER6:5:: j� „ f P H"O�C/- [ I�� _ • 6 O. 7
3. /l_/ /(J(J(X L� t
ADDRESS �� ZIP Required Set Backs in Feet
' �3oX I Y6g16 9Fait' North 'SouthEast (West 0 1 — 1 9-8 1
ONTRACTOR PHONE Size of Parcel Zone Classification
Dr+/ we.21- 13p, ) ' ""--R4 //—�� it a9-ly/6 6.479,
4' L./.2951,21)ESS f ZIP Type Const. Occupancy Sprinklered
/Q.J>Q o ; S ; D Lives ❑No CI Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
J. ADDRESS ZIP DWL Area I Basement Area Garage Area I Storage -
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
TYPE }�.., No. Baths No. Floors No. Rooms Rec. Room
❑ NEW ❑ ALT. ❑ AD'N. W RPL. ❑ MVE.
7, OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. X MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK FEES COLLECTED
VALUATION Source AS ELECTRIC WATER SEWER
of _
9. Utilities
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. Plumbing
DATE ` — / —" / SIGNATURE �__ / . r �' ' Mech. 1400
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
FOR GAS:
Env.Health ix
SEPA I-
Planning PIPE SIZES: F-
- w
CL.
Mobile Home cn
Fire Marshall PIPE LENGTHS: z
Co. Engineer / • Other (Specify)
BTU'S: `5O6 lj�i,
Utilities / ))
TOTAL $C3/- 6.0
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist r THIS COM ,A ERMIT.
DATE OFF'
APPRI r r' ISSUANCE —