1980, 08-07 Permit: 80-8245 FurnacePLAN NUMBER
APPLIC&flON/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
2.
3
JOB ADDRESS
LOT
OWNE
ADD
BLOCK
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 -COPIES
5 BDIVISION
E
779
/ a//hy---7?-a/
CO//79�R
4' E T -
�W
ar
ADDR
DESIGNER
6. ADDRESS
P ONE
26- 5613
ZIP
f9�206
P ONE
117
96167
ZIP
f9268r
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/5
Actual Set Backs in Feet
North !South East (West
Size of Parcel Zone Classification
Type Const.
Occupancy Sprinklered
❑Yes CNo 0 Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
UM in. Basement
TYPE 0 NEW
7. OF
WORK 0 BLD.
DESCRIBE WORK
8.
VALUATION
9.
O ALT. 0 AD N. 0 RPL. 0 MVE.
O PLMB. 0 MECH. 0 M.H. 0 POOL
SOURCE
' OF
UTILITIES
GAS
ELECTRIC 1 WATER 1 SEWER
kKX
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Location (Area)
Ownership
Public 0 Private 0
USE CODE
Req'd.
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
/( f/ v SIGNATURE OF APPLICANT '
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Eire Marsha
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS: . .
PERMIT IS NONTRANSFERABLE
Rec'd.
Not Req'd.
FEES COLLECTED
Single• $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 7°Ce
PERMIT NUMBER
SD
04* *7.00
. *7.00
*7.006
E .*000
8242
'08-07'-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
8 2°43 z
PERMIT NO.
*7, 0:0a1-2
TOTAL