1980, 08-11 Permit: M80-8377 InsertPLAN 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
1.
2.
3.
JOB ADDRESS
East 16120 Broad
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
William Schoenfeldt
PHONE
926-6075
PARCEL NUMBER/S
ADDRESS
East Via 16120 Broad
2199216
Required Set Backs in Feet
North 'South [East 'West
4.
CONTRACTOR
Western Thermal Systems
PHONE
483-1017
Size of Parcel I Zone Classification
ADDRESS
North 2315 Division
ZIP
99207
Type Const.
Occupancy
Sprinklered
❑Yes ONO ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation (Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
7.
TYPE
OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
El PLMB.
❑ AD'N.
MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. Install Alaska Kodiak Large Insert
VALUATION
9.
Source
of
Utilities
GAS
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 of construction.
DATE 8/11/80 SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
_ OFF
APPR►''IR ISSUANCE -
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
DATE
/4
PERMIT NUMBER
✓�' -5 X71
04*
A
837.68
08-11-80
g 6479.
*7.00
*7.00
*7.006
*0.00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS CO S,A EMIT. 1 — 837.7 z
* 7.0..0, a I(-