1980, 10-09 Permit: 80B-1727 FurnacePLAN NUMBER
('2
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH e11 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3.COPIES
JOB ADDRESS
2.
1-26-52K ISUBDyVISION
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER'S
OyTER
3 /J ttet. c'
ADDRESS
CO TRACTOR
5.
ADDRESS
sd et2P1
DESIGNER
PHONE
9z8 9a 5-/
ZIP'
99.za/
Actual Set Backs in Feet
North 'South
East
'West
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes 0No 0 Req'd.
PHONE
Valuation
Building Area in Sq. Ft. .
ADDRESS
ZIP
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfln. Basement
TYPE
7. OF
WORK
9.
O NEW
❑ BLD.
O ALT.
❑ PLMB.
ESCRIBE WORK
Atai
VALUATION
SOURCE
OF
UTILITIES
0 AD N.
14 MECH.
K will
❑ MVE.
0 POOL
GAS 1 ELECTRIC 1 ' WATER
1
0 OTHER
0.ai (:/i
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public 0 Private 0
Location (Area)
USE CODE
Req'd.
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
OF APPLICATION / D — / —Fee
SIGNATURE OF APPLICANT azThb (tit -
DATE
SPECIAL APPROVALS
NAME DATE
Env. Health
fanning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
BRIIng Tech iciT t,
Q/7
SPECIAL CONDITIONS:
.Ifr,v,�e.a-s-?
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED •
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Sf 7o
•
Other (Specify)
$17 66.
TOTAL $
PERMIT NUMBER
80a—/7 -t7
04*
*7.00
*7.00 y
*7.006
A *Q00
1 7.262
10-09=8.0
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
avo
DATE ISSUED
1'`72,72 *700aEt' -
PERMIT NO. TOTAL