1980, 02-14 Permit: 80-1172 FurnacePLAN 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 4 COPIES
JOB ADDRESS
C �7�oon�
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK SUBDIVISION
COY UOrx)e1 amai..:206N,,45
ADJ ES ZIP
520.5 ? 2P Ci 99.90 0
PHONE
NTRA TOR
4. o jl G FISC e.
AD r'RESS
/O// Di V,S1d('1
PARCEL NUMBER/S
Required Set Backs in Feet
North (South East
West
P--/5..7 /
Size of Parcel
DESIGNER
5' ADDRESS
6.
CHANGE OF USE FROM
❑ NEW
❑ BLD.
TYPE
7. OF
WORK
El ALT.
❑ PLMB.
ZIP
C'cL,„2oa
PHONE
ZI P
TO
❑ A N. ❑ RPL. ❑ MVE.
MECH: ❑ M.H. ❑ POOL
❑ OTHER
Type Cons
Occupancy
Zone Classification
Valuation
DWL Area
Split Entry
Basement Area
Sprinklered
❑Yes LINO ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
No. Baths
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
Storage
Rancher
No. Rooms
Rec. Room
Req'd.
Rec'd.
Not Req'd.
1..2f.„S.CRIBE WOR
Pia"
VALUA ION
9.
?a zO ,e0/
Source
of
Utilities
GASB
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 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 oc onstru tion.
DATE
�„g,Q
SIGNATUR
/ /A 1I6/, -I-J
91 WD
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL COND TI
�3TU' S —
DATE itI OOFFICIA 1 "''-''"-
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $/
DATE
PERMIT NUMBER
'6
04* *14.00
* 1 4.00
* 14.006
E *0.00 8
117.18
02-14-80
g 6,479.
(j0
oU
.mac%
2 o"
•
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
117,25 *1400.2F
L