1980, 01-08 Permit: 80A-9927 FurnacePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
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DATE 8 --)-1 ` ? 9
04* *120.0
*12.00 N
* 1 200
E *000 COD
9926
01-08-80
6.479,
VALUATION
APPLICANT: COMPLETE NUMBERED SPACES -
PRESS HARD TO MAKE 4 COPIES
1.
JOB ADDRESS
, 33
LElc11.S
LEGAL DESCRIPTION - SEE ATTACHED
of
Utilities
LOT
BIL CK
SUBDIVISION
Single $
PARCEL NUMBER/S
2.
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
OWNER
Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
PHONE
3.
T- A k;
performance of construction.0-0
Plumbing
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ADDRESS
DATE 7 y _ SIGNATURE
Mech.
ZIP
Required Set Backs in Feet
JJr
L._ %j f S
":
/
Plan Check
North South East West
6 - / i1
CONTRACTOR
Planning
PHONE
Size of Parcel
Zone Classification
4.
Mobile Home
Fire Marshall
ydy-Yo'7
Other (Specify)
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
TOTAL $
0 (d ,.
L
:—
❑Yes [—]No ❑ Req'd.
SEPA Checklist
DESIGNER
THIS BECOMES A PERMIT.
'7
DATE OFFICIAL�`/:f/4/�
PHONE
Valuation
Building Area in Sq. Ft.
5.
Pt S
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
6.
CHANGE OF USE FROM
C)C\
TOJ
Split Entry
Split Level
Rancher
TYPE E] NEW
NALT. 1:1AD'N.
❑ RPL.
ElMVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
WORK 1:1BLD.
1:1PLMB. Q MECH:
❑ M.H.
E] OTHER
❑ POOL
CERTIFICATE Req'd.
of EXEMPTION
Recd.
Not Req'd.
DESCRIBE WORK
8
0
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J
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FEES COLLECTED
PERMIT NUMBER
C FdA - ftp
DATE 8 --)-1 ` ? 9
04* *120.0
*12.00 N
* 1 200
E *000 COD
9926
01-08-80
6.479,
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
9.
of
Utilities
Single $
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
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 regulati g onstruction or the
performance of construction.0-0
Plumbing
DATE 7 y _ SIGNATURE
Mech.
SPECIAL APPROVALS
SPECIA CONDIytb
DEPT. REQ'D. RECD.
":
/
Plan Check
Env. Health
6 - / i1
SEPA
Planning
,r ,rT�J
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
_� ^ 7
i
THIS BECOMES A PERMIT.
'7
DATE OFFICIAL�`/:f/4/�
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