1981, 01-30 Permit: 81A-1028 FurnacePLAN NUMBER
APPLICATION/PERMIT
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
LOT
BLOCK SUBDIVISION
3.
OWNER elA
(pia.
PCA60)0
hjO-N�E/
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL N*OMBER/S
ADDRESS
CONTRACTOR
L.44
4' AD&RESS
DESIGNER
5.
ADDRESS
,907
PH'�NEEE LL//�S
ZI9aol
PHONE
Actual Set Backs in Feet
North !South
Size of Parcel
Type Const.
Occupancy
East
(
West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building lding Area in Sq. Ft.
ZIP
Main Floor
Garage Floors Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
O PLMB.
Ir AD'N. 0 RPL.
WMECH. 0 M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.,'Ln4(1,e-e-- 2 f,3b--'ay)gq_i
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
num. Dist. Location (Area)
ELEC IC WATER SEWER
Ownership USE CODE
Public ❑ Private 0
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
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 INSPECTIO
DATE OF APPLICATION
1-1 )r
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklis
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
/7,60
PERMIT NUMBER
LI -A - (� �
04* *17.00
* 17.00 17)
* 1 7.006
A *0,00
102,7
01•-30-81
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
,01,k. 3,0 -.8'.1
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
10285 *17,002,4
PERMIT NO. TOTAL