1981, 01-29 Permit 81A-0984 Furnace1Vv V10MK
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
1 LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK SUBDIVISION S PARCEL NUMBER/S
2.
OWNER _ PHONE
3.
ADDRESS _ ZIP`, Actual Set Backs in Feet
7ill U� G 1`0 v, ,, Le North South East West
CONTRACTOR
of
e r n L/n�i►�i52�� �
Li
PHONE
J h ��%,/.
Size of Parcel
Zone Classification
4'
FEES COLLECTED
>`//Lji�/9G.�
.G ..L�f�'L�
.✓
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public El Private ElSingle
AD RESSi 2 h'1 _
/ L L6Vj� -
�Q �
/�
r/
A/--;
ZIP
�����
Type Const.
Occupancy
Sprinklered
DATE OF APPLICATION / �.e17 O
SIGNATURE OF APPLICA1
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Plan Check
❑Yes ❑No ❑ Req'd.
DESIGNER
SEPA
Fire Marshall
Mobile Home
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
Upper FloorstReq'dRecld.eq'd-
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finishednfin.
Basement
6.
TYPE
❑ NEW ❑ALT.
❑ AD'N.
y�r `
K7�RPL.
❑ MVE.
No. Baths
No. StoriesNo.
of Dwellings
7,
OF
WORK ❑ BLD. ❑ PLMB.
ikMECH.
❑ M. H.
❑ OTHER
❑ POOL
CERTIFICATE
ns Examin
U' 1PERMIT NUMBER
6, t /V 9 cx�,6
04* ;*11J00.
*;1700
*17006
A *0.00
9
01-29-81
.2 6479,
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
r- PERMIT IS NONTRANSFERABLE ' /�
—� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE 4J: 1.9 -QJ 6'
DAD" 1 PERMIT(rIQ.A'cl , � „TOTAL
EXEMPTION
DESCRIBE WORK _ _Enum.
8.�`CG' GyfG ��tf6✓.e9X �i�iu �l%�i�f'�/
Dist.
%/
Location (Area)
FEES COLLECTED
>`//Lji�/9G.�
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public El Private ElSingle
$
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 REVE�R/SE SIDE FOR REQUIRED INSPECTIONS
Plumbing
DATE OF APPLICATION / �.e17 O
SIGNATURE OF APPLICA1
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
Planning
SEPA
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
ns Examin
U' 1PERMIT NUMBER
6, t /V 9 cx�,6
04* ;*11J00.
*;1700
*17006
A *0.00
9
01-29-81
.2 6479,
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
r- PERMIT IS NONTRANSFERABLE ' /�
—� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE 4J: 1.9 -QJ 6'
DAD" 1 PERMIT(rIQ.A'cl , � „TOTAL