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1980, 04-10 Permit: 80-3362 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. LEGAL DESCRIPTION - SEE ATTACHED LOT 2. BLOCK UBDIVISION OWNE 3. ADDRESS CO 4. PHONE PP-6 PARCEL NUMBER/S PHON0,0E ZIP Required Set Backs in Feet North (South Size of Parcel Type Const. Occupancy East 'West Zone Classification Sprinklered ❑Yes ❑No ❑ Req'd. DE IGNER 5. ADDRESS PHONE Valuation Building Area in Sq. Ft. ZIP DWL Area Basement Area Garage Area I Storage CHANGE OF USE FROM 6. TO Split Entry Split Level Rancher TV PE 7. OF WORK ❑ NEW ❑ BLD. ❑ ALT. ❑ PLMB. ❑ AD'N. ❑ MECH: ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL ❑ OTHER No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE WORK 8. VALUATION 9. Source of Utilities GAS ELECTRIC WATER SEWER I hereby certify that I have read and on reverse side, and know the same type of work will be complied with to give authority to violate or cancel performance of construction. DAT (/ /di ll examined this application and have read the "NOTICE" provisions included to be true and correct. All provisions of laws and ordinances governing this whether specified herein or not. The granting of a permit does not presume the provisions of any other state or local law regulating construction or the SIGNATURE SPECIAL APPROVALS DEPT. R EQ' D. RECD. Env. Health Plann ing Fire Marshall Co. Engineer Util ities Zone Clearance SEPA Checklist SPECIAL CONDITIONS: • DATE OFFICIAL_ C APPROVED 0 ISSUANCE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 7/° PERMIT NUMBER $C-33c.z DATE *7.00 *7,00 *7.00 E *000 3361 04-10-80 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. '-IlO-80 X56.20 *7.002