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1980, 09-09 Permit: 80-9837 FurnacePLAN NUMBER 1) 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 ADDRE� _ I 1,217\4071LOT BLOCK SUBDIVISION OWNER ,�yl ,� 3. ! -AD ADDRESS 'ONT�'s-9.‘- ideatc PHONE4. 4C- • r AD D.R ESS, P ONE DESIGNER 5. ADDRESS CHANGE OF USE FROM 6. TYPE 7, OF WORK ❑ NEW ❑ BLD. ❑ ALT. ❑ PLMB. 1' rbc 7 PHONE ZI P TO AD'N. MECH. ❑ RPL. ❑ M.H. ❑ MVE. O POOL 0 OTHER LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S Actual Set Backs in Feet North South Size of Parcel Type Const. East West Zone Classification Sprinklered ❑Yes ❑No ❑ Req'd. Valuation Main Floor Building Area in Sq. Ft. Garage Area Storage DESCRIBE WORK VALUATION 9. SOURCE OF UTILITIES GAS CTRIC WATER SEWER No. Baths CERTIFICATE of EXEMPTION Enum. Dist. Location (Area) Ownership Public 0 Private 0 USE CODE hereby certify that I have read and examined this appiication 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 INSPECT S DATE OF APPLICATION SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Enginee Utilities Plans Examine SEPA Checklist Building Technician SIGNATURE OF APPLICANT SPECIAL CONDITIONS: Po„ccioJ FEES COLLECTED Single $ Building Plumbing Mech. c7� u p ,00 Plan Check SEPA Mobile Home Other (Specify) TOTAL $ f `(32) m PERMIT NUMBER if90 983 7 04* *9.00 * 9.00 * 9.006 R *000 9822 09-09-80 6.479, • WHEN MACHINE VALIDATED IN THIS SPACE, PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE THIS BECOMES A PERMIT. 019.-.q 98.37 Z *9.00.° DATE ISSUED PERMIT NO. TOTAL FII F rflPY