1981, 10-02 Permit G81B-0194 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
PERMIT NUMBER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
ei
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
/ I z/' 6 i-OC,L�X_u%C�
LOT BLOCK SUBDIVISION
OWNE
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
ADDRESS
CONTRA TOR
4. � %44,71 /C/[.il+�� i -r �`e
ADDRESS
JJ •Z
DESIGNER
5.
ADDRESS
ZIP
PHONE
PHONE
Actual Set Backs in Feet
North (South
Size of Parcel
Type Const.
Valuation
Occupancy
lEast
Wes
Zone Classification
Sprinklered
Lives ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basemen
Unfin. Basement
TYPE EW
7. O F �.til-+�4
WORK ❑ BLD.
DESCRIBE WOR
VALUATION
9.
❑ ALT. ❑ AD'N. ❑ RPL.
❑ PLMB. 4tgrsliECH. ❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
SOURCE "GAS ELECTRI WATER I SEWER
O F (/)
UTILITIES
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Ownership
Public ❑ Private ❑
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.ioSEE REVERSE SIDE FOR REQUIRED INSPECTIONS �` J
DATE OF APPLICATION '�"'� £e/ SIGNATURE OF APPLICAN? A c /// �{
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
Rec'd
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ / if�
04* *1600
* 1600
* 16006
A *0.00 0
19,3
10-02-81
-2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE
,10,-0 2'-81
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
19.4z
PERMIT NO.
*16.00R -
TOTAL