1980, 12-29 Permit: 80B-5248 Furnace, Heat PumpPLAN NUMBER
U
APPLICATION/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
1.
2.
JOB ADDRESS
g /2926 GOTHE1
LOT SUBDIVISION
BLOCK
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
OWNER
3. RAsts5gL_
ADDRESS
PHONE
gad - /
5 3E-07 Na,cpirr
CONTpt ACTOR
a. /{ PM (PUaL cry N 44Tiw',
ADDRESS
5 /z7/0 /A/0774W A
ZIi,oZV%
Actual Set Backs in Feet
North 'South East 'West
PHONE
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Oyes DNo 0 Req'd.
5.
DESIGNER
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
-Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
IPI NEW - 0 ALT. 0 AD N. 0 RPL. 0 MVE.
0 BLD. 0 PLMB. 117 M/ECH. 0 M.H. 0 POOL
DESCRIBE WORK
8./N57m`1ut ELEc Fu/ZA/ 41 Putt # K6ATr
0 OTHER
Pum P•
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC WATER
vcta-P
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 Ip4 • 2 3.- EC)
SIGNATURE OF APPLICANT
maw
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Eng
Utllitie
Plans Examine
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.. J `7' 00
Plan Check
'SEPA
Mobile Home
Other (Specify)
TOTAL $ 1°6
/11
PERMIT NUMBER
grDL3=5'z f8
04* *1300
*1300 N
*130.06
A *000
52&7B
12-29-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
5r2'&81r *11002
DATE ISSUED PERMIT NO. TOTAL
1