1980, 05-06 Permit: G80-4348 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
1.
LOT
2.
BLOCK
It aos
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
OWNER O J I n
ADDRESS
I/ 2, o`) G V r'
PHONE
PARCEL NUMBER/5
ZIP
Required Set Backs In Feet
North 'South
East 'West
CONTRACTOR (4.
)
PHONE
SZ
Size of Parcel 1 Zone Classification
ADDRESS -
ZIP
g9a4 Co
Type Const.
Occupancy
Sprinklered
❑Ves ❑No ❑ Req'd.
5.
DESIGNER
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
OWL Area I Basement Area r Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
O ALT.
O PLMB
❑ AD N. /a RPL. ❑ MVE.
MECH: I] M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
/SO 0 00 , oA
/
Source I GAS
of
Utilities
I xx
ELECTRIC
WATER
SEWER
I hereby certify that 1 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.L,, J/� ,,�� pit DATE S— Z— SIGNATURE L)Cp,t,sJ.-Jib-4 20 0 Yi1
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health •
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE 5.42/72
'/ 0FFICIAL 1 V.A l1XMM.(Th
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
iqe
PERMIT NUMBER
DATE S— 7.-31
04* *14.00
* 1400 45
* 14..006p R
5 *000
454.72
05-06-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOME A PERMIT. I
W4011;0; ?i0'' 1;0; 4''3;485 *14.0,OtaJ
CC
0
O
0
UJ
UJ
0