1980, 01-15 Permit: G80-244 FurnacePLAN NUMBER
f).
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 '
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS 43
LOT BLOCK SUBDIV ION
2.
3. opiNTL#d
- 124244;
ADDRESS
f,6411
D
sc .e�rl,
CONTRACTOR
4' •D�S.,
ADES
DESIGNER
at
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
PHONE
6' ADDRESS
ZIP
Required Set Backs in Feet
North 'South [East 'West
PHONE
Size of Parcel I Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
PHONE
Valuation I Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
7.
TYPE
OF
WORK
0 NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
❑ BLD. 0 PLMB. �I MECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
DESCRIBE WORK
8. P.e-wr L iti � . �. r„�->u�c L. 51;- ?ila� u,fta kta
VALUATION
9.
Source I GAS
of
Utilities
ELECTRIC
WATER
SEWER
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 correc . 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.
DATE RD SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
?SD DD 137-0
-r
a
p/P.E 2/
/r
p/PS
DATE OFFICIAL ,,P, ati croa
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
O
/2
TOTAL $ 1—'-
G
PERMIT NUMBE4'
DATE
04* *1200
*120.0
24.38
01:15'-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
01 J 1151. •8''0
•
2448 *120Oa1-
RECORD OF INSPECTIONS
#1S0, !
O -;
Final Inspection
- DATE - - -- -. REMARKS . _ - INSPECTED BY
3V'