1980, 01-31 Permit: 80-755 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
36,16 E)Yo/V
LEGAL DESCRIPTION — SEE ATTACHED
LOT,
2.
LOCK
SUBDIVISION
OWNER3 r 4 w 1 S F/ R
ADDRESS
Al . 36/4 )1-7"/v
CONTRACTOR
4. AD /ESSU R £ vT / 7Y G'
DESIGNER .
5.
PHONE.
�' P (, FIs'
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South 1East 'West
PHONE
3 y- yy 75
Size of Parcel I Zone Classification
ZI P
f 4
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation 'Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area
Basement Area 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ N1Vti- 0 ALT. 0 AD N. 0 RPL. 0 MVE.
0 OTHER
0 BLD. 0 PLMB. MECH: ❑ M.H. 0 POOL
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESC RII E WORK ��yy �./
8.
VALU ION Source GAS ELECTRIC WATER'
of ..
9. Utilities
�Ud•040
SEWER
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
• FEES COLLECTED
Single $
Building
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE P31 O OFFICIAL
(TAT'
cpfilanevAn.krio,,..
APPROVED FOR ISSUANCE
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
6 0
''Co
PERMIT NUMBER
950-'755'
DATE 2/ /
04* *1200
*12,00 n
*.1200,5
E
*G0'0 8
7548
01.=31'-80
6479.
l—
U
_ w
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'0,,1.1 .15 _ �:.of