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1980, 12-18 Permit: 80B-5004 FurnacePLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER SPOKANE COUNTY -- BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES JOB ADDRESS 0 4 * * 1 1.00 c.. 1. S �� t�1Jl � LEGAL DESCRIPTION - SEE ATTACHED * 1 1.0 0 LOT BLOCK UB I ISION PARCEL NUMBER/S 2. * 1 1.0 0 6) OWNER ( PHO ADDRESS /� / ZIP / Actual Set Backs in Feet Al y� ��� 5 0 0 3 North South East West C NTRACTOR PHIE Size of Parcel Zone Classification Al 12-1 8-80 4' 6.479. `� -ApDRESS onst. Occupancy SprinDyes ered kl❑ I / /I� ZIp�D�[an //ir/ 40,- /`l /Gj // ❑No Req'd. DESIGNER PHONE Building Area in Sq. Ft. 5.} Upper Floors Garage Area Storage ADDRESS ZIP 77-1 - CHANGE OF USE FROM TO of Decks Finished Basement Unfin. Basement s. aths No. Stories No. Rooms No. of Dwellings TYPE NEW ALT. ❑ AD -N. RPL. ❑ MVE. 7. OF WORK ❑ BLD. ❑ PLMB. WMECH. ❑ M. H. ❑ POOL 1-1 OTHERRTIFICATE Req'd. Recd. Not Req'd. EXEMPTION D SCRIBE WORK Dist. Location (Area) —FEES COLLECTED 8 � . li� ��� � j � /�%�/ j��V146— VALUATION VALUATION SOURCE GAS ELECTRIC WATER SEWERpUSE CODE9. UTILOITIES Private ❑ Single $ 1 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 Building 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 Plumbing I©C) DATE OF APPLICATION SIGNATURE OF APPLIG�'A�iF'/sCryG' Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: NAME DATE Plan Check Env. Health SEPA Planning Fire Marshall Mobile Home L L Co. Engineer Other (Specify) - s Plans Examiner SEPA Checklist �f PERMIT IS NONTRANSFERABLE ''- PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE TOTAL $ // WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 50a4111, DATE ISSUED PERMIT NO. 00(OL ; - TOTAL