1980, 04-03 Permit: 80-3057 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDIPNGCGDES DEPARTMENT.
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456.3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES -
JOB ADDRESS
1. S. 3 c%/d
LOT
2.
/ DX
LEGAL DESCRIPTION — SEE ATTACHED
BLOCK
SUBDIVISION
PARCEL NUMBER/S
3.
OWNER
Lyn
ADDRESS
7�10�
r. Co./r gaer-h).
G. /4 G/sc_
PHONE
9,z -viz k
ZIP
Yyaei6
Required Set Backs in Feet
North (South lEast 'West
CONTRACTOR ,/
4tv '4(4/% eciele,/ 4.f. 'r,4>itrete/ / [
4' ADDRESS J
E /d %/D
DESIGNER /
5.
PHONE
9tie -"vac/
Size of Parcel 1 Zone Classification
ZIP
99a/err
Type Const.
Occupancy
Sprinklered
❑yes ❑No ❑ Req'd.
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area r Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
❑ BLD. 0 PLMB. 0 MECH: 0 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
DESCRIBE WORK
8. /4/S 7`a //
VALUATION
9.
der L %wren �-
�.s.. £"tc JR et ae/ fit A.s 7C z'
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 tit— TV
SIGNATURE1G""-'i
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS: L -
DATE"? --3-33D OFFICIAL PO T\1 MgV's
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
,11—
Plan Check
Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ J' OCi
Iv1
PERMIT NUMBER
90-3057
DATE
04* *7.00
*7.00
*7.00'6
E *GOO
30.562
04.03-80
3 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
41.i 30'5.'75 *7,00