1980, 01-07 Permit: 80A-9870 FurnacePLAN NUMBER
"React
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. /2oa V 61wr e
LEGAL DESCRIPTION— SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWER/ c
3 lie /6 Pe / "Ks°
ADDRESS
r a v9(o �ci! .. S�rd.±Kt-e 44
PHONE
yd6-30aI
ZIP
990,3
Required Set Backs in Feet I
North 'South `East 'West
CONTRACTOR
//-i'/, Osco / /7 i/rte!/'t-q verA4e 4'c
4' ADDRESS
f.;2 ?id /-veie..-.r Sgd.taeie h/a
DESIGNER /
5' ADDRESS
PHONE
5%Z
Nay
Size of Parcel 1 Zone Classification
ZIP
yva/e,
Type Const,
Occupancy
Sprinklered
❑Yes LINO 0 Req'd.
PHONE
Valuation I Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
O PLMB
❑ AD N.
❑ MECH
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. /e/J/ac e CLt4lP..d.Y lv as
J:Ce 14
V UATION
9.
Source
of
Utilities
GAS
ter / D .. foe tet' •
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 /- 94 — G O SIGNATURE
SPECIAL -APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
SPECIAL CONDITIONS:/
ir4, 2 / t f( /up, oJO,' Brie
/if /I -A -c re.
6 save
"a4 r / J.&=Hr/P
FEES COLLECTED
Single $
Building
Plumbing
Mech. 3. o6
waer ' o0
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
co—Pr-gs-7o1
DATE
04* *1300
* 1300 N
* 13006
E *ao0
98691
01-0780
2 647.9.
•
CC
O
0
w
ti
Utilities
Zone Clearance
SEPA Checklist
DATE /—g-DOFFICIAL
APPROVED FOR ISSUANCE
TOTAL $ /3-40
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
011=''0'�/-'-110•
987.05