1980, 03-02 Permit: 80-2122 FurnaceFLAN NUMBER
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 LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK IbUHUIVISIUNJ I PARCEL NUMBER/S
OWNER
3. Don
ADDRESS L/
Al.
i
CONTRACTOR
AC
4. ADDRESSS
r. AR?/
DESIGNER
5. ADDRESS
CHANGE OF USE FROM ITO
6.
TYPE ❑ NEW
7, OF
WORK ❑ BLD.
DESCRIBE WORK
8.%n k-// XriF
❑ ALT. ,❑ AAD'N. El RPL.
ElPLMB. LAS MECH: ❑ M. H.
ONE
PHONE
90e
ZIP
9194
PHONE
ZIP
❑ MVE.
❑ OTHER
11 POOL
Required Set Backs in Feet
North (South
Size of"Parcel
Type Const. Occupancy
Valuation
DWL Area Basement Area
Split Entry Spli
No. Baths I No. Floors
CERTIFICATE
of EXEMPTION
ast (West
Zone Classification
Sprinklered
❑Yes []No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area I Storac
u
No. Rooms I Rec. Room
Req'd. I Rec'd. Not Re(
FEES COLLECTED
VALUATION Source GAS FjLECTRIC WATER SEWER
of
9. Utilities LtJvVlr Single $
1 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 Building
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 3
Plu b'
performance of construction. — I n Un
DATE• �as /(74G SIGNATURE �V Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: Fei" • 6.. C) e)
DEPT. REQ'D. REC'D. I , i/ Plan Check
Env. Health
Pianning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SEPA
Mobile Home
40 A/>� � �� !,C� 0 0 Other (Specify)
PERMIT NUMBER
DATE
OCA0
* 1 S
r
2121>
03-12-'0
6.[79
G'Y r"Gt r'6'
TOTAL $ ./<60
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE-1.2"DCJ0FFICIAL Q -MAA