1980, 05-19 Permit: 80-4911 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. S. F�f c sr.
LOT BLOCK SUBDIVIS
2.
LEGAL DESCRIPTION - SEE ATTACHED
3.
4.
5.
OWNER
SCALFP \ CUtJST,
ADDRESS/(
�
5. 72044 R uPRI UE' DR
44–./ Negri r'9/e/eonf7
ADDRESS
L-.45- til.ILF
DESIGNER
PHONE
ft4e-4
ZIP
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South - East (West
PHONE
/89-962/
990S)
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
Dyes DNo 0 Req'd.
PHONE
Valuation , - I Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
• TYPE
7. OF
WORK
)gr' NEW
0 BLD.
D ALT.
❑ PLMB
DAD N.
/"`/ MECH
D RPL.
O M.H.
0 MVE.
0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
1DESCRIBE WORK �J,, 11 �—• ne �(/�n (� ` f p�J
$ 'VALUAT ON i9 K. l/1/ FURttF10E A� I LWOe IC
IC
o " 5(9. Utilities T
WATER
SEWER
I hereby certify that I have read and examined this applica ion 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 FFI CI AL fC-fWl'I M.TiY�
I b APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /t00
PERMIT NUMBER
M-crao-NG 11
DATE
04'* *7.00
*7.00
*7008
E *000 8
491.08
05-19•=80
i 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
it.5k11'9;t! 8i0
49115 %00Dar2