1980, 12-30 Permit: 80B-5293 FurnaceAPPLICATION/PERMIT
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
1.
LOT
BLOCK
S.�oi Poi
SUB IV SIO
2.
OWNER
3. 6REM y, TNC
E• /0/06 5181
LEGAL DESCRIPTION — SEE ATTACHED
PHON4E
- 704
292
990704
PARCEL NUMBER/5
Actual Set Backs in Feet
North (South
East
IWest
CONTRACTOR
4.' All10V,esoN's 4/7'(, $ A/Ci
AREDRESS
f B7IC AiiftiStf/jrL,o
PHONE
9.28-0960
Size of Parcel
Zone Classification
ZIP
9070.4
Type Const.
Occupancy
Sprinklered
❑Yes DNo 0 Req'd.
DESIGNER
6 ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7; OF
WORK
TO
0 ALT. 0 AD N.
0 RPL. 0 MVE.
0 PLMB. 'MECH. 0 M.H. 0 POOL
0 OTHER
Area of Decks
No. Baths
Finished Basement
No. Stories
No. Rooms
Unfin. Basement
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
B eszenTTILITIES/c Tue.& f� DGcT LL, .eK
OF
9. U
VALUATION SOURCE GAS
C - o
E ECTRIC WATER
v
Enum. Dist. I Location (Area)
SEWER
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 1.247 lc/Pt, SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
cul ng Te tan
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
/
TOTAL $%ems
M
PERMIT NUMBER
eat3 - 92917
04* *7.00
*7.00 t5
*7.0015
A *000
529.2
12-30-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMESA PERMIT.
•tI ,
12-4.31a'x'8 U
PERMIT IS NONTRANSFERABLE (• I 51'2`',9,;j'
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED, PERMIT NO. TOTAL
#7.4)0Dai•-2
p_
0
0
IJJ—J
W