1980, 09-08 Permit: 80-9747 FurnacePLAN NUMBER
APPLICATION/PERMIT
, SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 611 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3.COPIES
1.
2.
3.
4.
JOB ADDRESS
o� til 1)RC-
LOT SUBDIVISION
BLOCK
LEGAL DESCRIPTION — SEE ATTACHED
OWNER yIo
ADO rioos . A- cvr51�j i -,
s, 2. corn b/ ciec..„ai
Comaactlb
PHONE
7246-4*n
'O7
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South '
East 'West
PHONE
Size of Parcel i Zone Classification
ADDRESS
ZIP
Type Const.
Occupan CY
Sprinklered
❑Yes IJNo 0 Req'd.
5.
DESIGNER
ADDRESS
PHONE
Valuation IBuilding Area In Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage ,
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfln. Basement
TYPE
7. OF
WORK
IBJ NEW
0 BLD.
❑ ALT. ,0 /AD N. 0 RPL.
4d
❑ PLMB. MECH. ❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
O 5 RIBE WORK
8. ODb
Ktdfice
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
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 ( .ntint,T rrperm' does not presume
to give authority to violate or cancel the provisions of any other sta or local law regulating corug4Zn or the
performance of construction. SE REVER SIDE FOR REQUIR a INSPECTIONS
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
7
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Cbecklist
SIGNATURE OF Ant CANT -e ' o
SPECIAL CONDITIOryryS:
�P.\» W I'V f' ls-r" g
or IdnvAicfr•. c�fl'J4
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
1
oO
Other (Specify)
TOTAL $
PERMIT NUMBER
- '747
04* *7.00
*700
*7.006
A *Q00
97462
09-08-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
t1li'E^08: 80
DATE ISSUED PERMIT NO. TOTAL
9'747-- *7,1O0aH
0
U
LLI
J
W