1980, 07-24 Permit: 80-7586 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
3.
JOB ADDRESS
r3 '
LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK
OWNR
,1i1,C(11,
ADDRES
eik
SUBDI V ISIO
� y O 71,c,
?HONE
--yZ/k.
ZIP
?'?106
PARCEL NUMBER/S
Actual Set Backs In Feet
North (South East 'West
CONTRACTOR •
4. �')`61-0 frf l w'fI72Q'
AD ESS.. /f
o ,,5 i Tr e f
DESIGNER
5. ADDRESS
PHONE
Size of Parcel 1 Zone Classification
ZIPqCA''O6
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd_
PHONE
Valuation (Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
❑ NEW ❑ ALT. 0 AD'N. aftYCL. 0 MVE.
0 BLD. ❑ PLMB. 0 MECH. 0 M.H. 0 POOL
DES R 18 E WO�2K
8.,. ft" -(1
VALUATION SOURCE
9.
OF
UTILITIES
Area of Decks
Finished Basement
Unfin. Basement
0 OTHER
GAS
ELECTRIC
WATER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private ❑
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
DATE OF APPLICATION_ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu
din echnl Ian
7�s//sd
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
80- 758G
04* *9.00
*9.00
*9.006
E
*GOO 0
758.38
07-24-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
D 7
758.65 *9.002.1 -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL