1982, 01-07 Permit: 82A-0094 FurnacePLAN NUMBER
t
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING- CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
k�p . APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1 r . I C - 7-, ,-7 LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK ISUBDIVISI,
2.
OWNER hUK
3. G �! --
PHONE
a7 2
ADDRESS J 1r^��.('
0
ZIP �f
Actual Set Backs in Feet
1
Lam"
North South East
West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
_-�\•'
4'
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
I 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 ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF yr ❑OTHER
❑ BLD. ❑ PLMB. YJ MECH. ❑ M.H. El
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DE
CRIBE
WOIR
�C
Enum. Dist. Location (Area)
FEES COLLECTED
8
�
e VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
OwnershipUSE
CODE
9. I
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
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
/
DATE OF APPLICATION SIGNATURE OF APPLICANTe�Jd
Mech.
_
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
nv. Health
anning
ire Marshall
o. Engineer
tilities
lans Examiner
EPA Checklist
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $�
PERMIT
N MBER
-
gS�z —00
q.* * 1 4,00
CI
*1400
r4 *0,!'tl
9.3L"
01-0,7-82
6.4 9
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
4.
01 07._82* 9.42 *1400a�
DATE ISSUED PERMIT NO. TOTAL