HomeMy WebLinkAbout1980, 08-15 Permit: 80-8623 FurnacePLAN NUMBER
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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
JOB ADDRESS .. _
1
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
2.
OWNER
3.
ADDRESS
+IPHONE
ZIP
Latek.e3
4.
CONTRACTOR
PARCEL NUMBER/S
PHONE
Actual Set Backs in Feet
North 'South [East (West
Size of Parcel
Zone Classification
ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
9 BLD.
❑ ALT.
9 PLMB.
PHONE
ZIP
TO
❑ AD'N. JZRPL.
9 M.H.
❑ MVE.
O POOL
0 OTHER
Type Const.
Valuation
Occupancy
Sprinklered
❑Yes 9 N ❑ Req'd.
Building Area in Sq. Ft.
Main Floor
Upper Floors
Garage Area
Storage
Area of Decks
Finished Basement
Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
9.
DESCRIBE WORK
VALUATION
Enum. Dist.
f, j 1'
ILocation (Area)
SOURCE
OF
UTILITIES
GAS
XA,
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private ❑
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 5 ` SIGNATURE OF APPLICANT .) -L 41C ,r Y
SPECIALmmimAPPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ZnTi
G��G
amu7leu✓
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $/
PERMIT NUMBER
g t3
04* *1200
* 1 2.00
* 12.006
E *0.00 8
86228
08-15-80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0,8 '-115r-.800 8 62,3
*12,00��
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL