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1980, 11-20 Permit: 80B-4002 FurnacePLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT • NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (5091 456-3675 APPLICANT: COMPLETE, NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES 1. JOB ADDRESS 2 z bS 2a[ bac re�ec) 4 LEGAL DESCRIPTION - SEE ATTACHED LOT 2. BLOCK SUBDIVISION PARCEL NUMBER/S 3. Dw8%9/'�" y3 1/ ADDRESS t � /) 30C �r�/ie v/t C. a `P±T7A�; d gem heti cmc. . Ws -80,c /4e5&' PHONE 924/adq ZIP Actual Set Backs in Feet North 'South East 'West %4-9/6P Size of Parcel Zone Classification z4 Type Const. Occupancy Sprinklered . Elves ❑No 0 Req'd. 5. DESIGNER PHONE Valuation Building Area in Sq. Ft. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage CHAT' GE pF USE FROM 6.nrI 'F,&r3c TO ii -J btie/t)%% (IC Area of Decks Finished Basement Unfin: Basement TYPE 7. OF WORK ❑ NEW ❑ BLD. ❑ ALT. ❑ PLM B. 0 AD N. MECH. ❑ RPL. O M.H. ❑ MVE. O POOL D OTHER No. Baths No. Stories •No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE WO 8. �GC/btt�eQi VALUATION 9. SOURCE OF UTILITIES ELECTRIC WATER SEWER Enum. Dist. I Location (Ar a) 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 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 /7-`42-4—P6 SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist B ' ding Te/ nicia �'v/ SIGNATURE OF APPLICANT /� SPECIAL�CONDITIONS: /0 c I.0 ©i I .1 .ict NHEE &tee/1 4a ' /.2 s; .grip 1i -2J -Z6 PM PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single $ Building Plumbing • Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL 8 od $ PERMIT NUMBER $ 65- q00, 04* A 4001'2 11'L20-80 2 6.479, * 1400 * 14.00 * 14.006 *0.00 8 WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 4o!a2:Z *1-4'0,oa1e DATE.ISSUED PERMIT NO. - TOTAL