1980, 05-19 Permit: M80-4915 Furnace, Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
1.JO
LOB D BLOC/ SUBDIVISION v(�
2.
LEGAL DESCRIPTION — SEE ATTACHED
3
OWJyER _
ADDRESS
PHONE
92 i-0 /7r2
21992 /.6
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East 'West
CO TRACTOR
a nt-o /fea t Co
CR 857 rre.77t
DESIGNER
5.
PADONE
PP3y-977 ,
Size of Parcel 1 Zone Classification
Z197.zo6
Type Const.
Occupancy
Sprinklered
Eves ❑No ❑ Req'd.
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
OWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
❑ ALT.
O PLMB.
LI 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.
$ DfSCRIBE LS
VALUATION
9.
adtit(19 62. /Itbbj 000
GAS
Source
of
Utilities
l7 ecu 1
ELECTRIC
ATER
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 correc . 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:
FOR GAS:
PIPE SIZES: %
04, -
PIPE LENGTHS:
BTU'S: /UOQ°OU
DATE OFF' CI AL �
APPROVED FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ f w -t -
Ir
DATE -SV/e, /76
PERMIT NUMBER
04* *1800
* 1800 5
* 18006
E *Q00 8
491.42
05=19-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THISy¢6CO?f AREjtM IT.
4 925•
*.18.00a�