1980, 03-21 Permit: 80-2514 FurnacePLAN NUMBER
it
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
1.
2.
3.
JOB ADDRESS
LOT
BLOCK
35x-1 -
SUBDIVISION
r
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
�y-,any
WL.tVv l' nJZ & '
PHONE
PARCEL NUMBER/S
ADDRESS
1 D _ rti� l
ZIP
Required Set Backs in Feet
North 'South
East
(West
4.
CONTRACTOR
PHONE
i'a- —zs
F^,
Size of Parcel
Zone Classification
ADDRESS
7309
ZIP
Type Const.
Occupancy
Sprinklered
Oyes ONo 0 Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area
Basement Area I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE SPI NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
7. OF C
WORK 0 BLD. 0 PLMB. R.MECH. 0 M.H. 0 POOL
DESCRIBE WORK
8.
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
VALUATION
9
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 off construction.
3
DATE —0-k— 'cps SIGNATUREU�-r - �J"d.(• �A 0 �
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE J-Ol I ii5CIDFFI CIAL a- L\n/i'ini.(511
APPROVED FOR ISSUANCE
Re 'd. .
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
v
TOTAL
PERMIT NUMBER
M -%p- 9%5 V{
DATE—I<("'Ssh
04* *7.00
*7.00
*7.006
E *GOO 8
_251.38
03-21-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMESA PERMIT.
a 5!-2-1.11:; ig,10,
25.1.42 *7400: