1980, 08-22 Permit: 80-8997 Furnace, Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
3
JOB ADDRESS
A./) . / / J
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWNERf
•
ADDRESS
4.
5.
PHONE
575763
CO 11 �fR(? / D--- &2
.ii- _e_--rs-
z39, 66
Actual Set Backs in Feet
North (South [East (West
PHONE
Size of Parcel 1 Zone Classification
DESIGNER
ZIP
PHONE
Type Const.
Occupancy
Sprinklered
Oyes ❑No 0 Req'd_
Valuation 1 Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
DESCR E WORK
8.
TO
Area of Decks
Finished Basement
Unfln. Basement
❑ NEW
O BLD.
❑ ALT. 0 AD'N. ❑ RPL. 0 MVE_
❑ PLMB. /MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
VALUATION
9.
SOURCE
OF
UTILITIES
g --C7-4, • &al 74ade, ';4 keti:
ELECTRIC
x
GAS
WATER
SEWER
Enum. Dist.
Ownership
Public ❑ Private 0
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 SIGNATURE OF APPLICANT
SPE:;IAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building echnician
SPECIAL CONDITIONS:
090 etA) • c .�e.' L-- ems,
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single S
Building
Plumbing
Mech. 1 -
Plan Check
SEPA
Mobile Home
Other (Specify)
7 et)
TOTAL $
PERMIT NUMBER
8c5 -899 7
04* *1300
* 1300 t
* 13,008
E *0.00 8
899.0
08-22-80
61479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
8.-42 261 8.0 8 9 `9:7' z
*13.00.°
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL