1980, 04-29 Permit: M80-4065 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
LOT BLOCK
OWNE
ADDR
SUBDIVISION
d/i,e6, J%i. ®/IVdie,
CONTRACTQ
4. ADDR
DESIGNER
ADDRESS
CHANGE OF USE ' ROM
6.
TYPE
7. OF
WORK
8.
1477--4/7-/:7
4/Y00(;
PHO E
cf cf_ //7e
ZIP
9220
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
ZIP
TO
0 NEW 0 ALT. ❑.,/AD'N. 0 RPL. ❑ MVE.
0 BLD. 0 PLMB. USl MECH. 0 M.H. ❑ POOL
DESCRIBE WORK
VALUATION
9.
Source
of
Utilities
❑ OTHER
e ehe,rA.41i
GAS
ELECTRIC
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
Valuation
DWL Area
Basement Area
Split Entry
No. Baths
Building Area in Sq. Ft.
Garage Area
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
WATER
Storage
Rancher
No. Rooms
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 SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
FOR GAS:
PIPE SIZES:
PIPE LENGTHS:
BTU'S:
DATE
OFFICIAL
Ammr:51v
APPROVED FOR ISSUANCE
Rec. Room
FEES COLLECTED
Single $
Building
Plumbing
700
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
oo
TOTAL $ /
PERMIT NUMBER
M (bO- )-101o'
DATE
04* *7.00
*7.00
*7.006
E *000 0
4064
04-29-80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOIVES A PERMIT.
4-29-80 0‘6,5z
*7.00°