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1980, 01-11 Permit: 80-73 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. / B LOT SUBDI IG ISICTvi� LEGAL DESCRIPTION - SEE ATTACHED 2. OWNER 3. M/0, �R' 1-1/4 ADDRESS PARCEL NUMBER/S PHONE ZIP Required Set Backs in Feet North 'South tEast 'West CONTRACTOR AgDRESs PHONE ./7/,/ • /2- 2-, /71- -- - ',9 ji�C� -�✓ DESIGNER 5' ADDRESS Size of Parcel 1 Zone Classification Type Const. Occupancy Sprinklered Oyes ❑No ❑ Req'd. PHONE Valuation (Building Area in Sq. Ft. ZIP DWL Area I Basement Area Garage Area Storage CHANGE OF USE FROM 6. TO Split Entry Split Level Rancher TYPE 7. OF WORK ❑ NEW O BLD. O ALT. O PLMB. ❑/AD'N. RPL. 0 MVE. ,tel MECH: 0 M.H. 0 POOL 0 OTHER No. Baths No. Floors No. Rooms Rec. Room CERTI FICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DE CRIBE WORK VALUATION 9. Source of Utilities GAS ELECTRIC WATER 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: DATE I— I lc l)cD OFFICIAL n nnnnvrn rnn tont i A nunr FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ ! ' ©o DATE PERMIT NUMBER 04* *9.00 *9.006 E *GOO 7.2R. 01-11-80 6Li. 79, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. �. ..1 c n, 3 ;� *9.01 21= INCPrrTf P