1981, 04-09 Permit G81A-3282 Furnace, Wtr HtrPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
I ChiIVII 1 IN VIVIDCrs
sr
S bye — 32
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1 LOT
2.
OWNER
3.
LEGAL DESCRIPTION — SEE ATTACHED
BLOCK
SUB ISION
l� c•.—�.�, C.5\,4
ADDRESS CS
lf)/2(-0
NTRACTO``R4
(�
ADDRESS
PHONE
ZIP
PHONE
PARCEL NUMBER/S
Actual Set Backs in Feet
North _I South [East (West
Size of Parcel 1 Zone Classification
ZI P
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
. NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. lajMECH. ❑ M.H. 0 POOL
❑ OTHER
Area of Decks
No. Baths
Finished Basement
No. Stories
No. Rooms
Unfin. Basement
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
9.
DESCRIBE WORK
L(0112.. (0 C3po c71� 1 U
SOURCE
OF
UTILITIES
GAS
x
Enum. Dist.
L11,0 0
SOwnersh ip
ECTRIC
WA ER
Public ❑ Private ❑
Location (Area)
USE CODE
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 INSPECTIONS
DATE OF APPLICATION l SIGNATURE OF APPLICANT v1°•' +\Cal4
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
VA-4'
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
04* * 1 7.00
*17,00
* 1 7,006
A *0,00 0
32812
04-09-81
6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
C
L
VALUATION
Building Tec
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
0 '4it 8i'9 - 81
DATE ISSUED
328.2g
PERMIT NO.
*1700°a1-2
TOTAL