1981, 10-13 Permit: 81B-0622 FurnacePLAN NUMBER APPLICATION/PERMIT ,�f PERMIT NUMBER
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
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
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LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
Zone Classification
OWNERPHONE
4. ADDRESS /
ZIP /
/(j
3.
u Z c- 0/a 2
903 1/ -$ 9 3
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ADDRESS
ZIP
Actual Set Backs in Feet
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North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4. ADDRESS /
ZIP /
/(j
Type Const.
Occupancy
Sprinklered
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uZ-
❑Yes ❑No ElReq'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
I Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
I
w
Baths
No.
Stories
No. Rooms
No. of we inc
TYPENo.
❑ NEW 1-1 ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
❑ BLD. ❑ PLMB. ❑ MECH. ElM.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req' c
WORK
4
of EXEMPTION
DESCRIBE WORK
Enum. Dist. Location (Area)
$ NS A, --a C C 0&, e �`l
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WAT R
SEWER
Ownership
USE CODE
9.
UTILOITIES
Public ❑Private ❑
Single $
1 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
Plumbing
DATE OF APPLICATION ;4c.,r$/ SIGNATURE OF APPLICANT
Meech. Zbll
SPECIAL APPROVALS
SPECIAL CONDITIONS:
� y' vU
NAME DATE
ePlan
Check
Env. Health
SEPA
Planning
Fire Marshall
Co. Engineer
ans Lxaminer
ec
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Mobile Home
Other (Specify)
TOTAL $ "Va
04* *1400
*14:00
* 1 4.0016
A *0:00
6 2. 1 7
10- 13-81
6,479:
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
6 Z2 25
DATE ISSUED PERMIT NO.
*1k000 -
TOTAL
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