1980, 03-11 Permit: 80-2028 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
A
PERMIT NUMBER
'3a - aoa%
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PR, ESS HARD TO MAKE 4 COPIES
JOB ADDRESS //^/' /�Ay//f�[sJ�
BLOCK 1SU6`DIV?SION
& t
ADORE6r
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs In Feet
North 'South East 'West
�TRArR
jinni .1 J,/.
'A7 15,94 kb?,
DESIGNER
6. ADDRESS
PHONE /_/Ay`l
PHONE
Size of Parcel Zone Classification
Type Const.
Valuation
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
ZIP
DWL Area l Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE 0 NEW
7. OF
WORK 0 BLD.
❑ ALT. }/
❑ PLMB. ' YJ MECH:
TO
❑ AD N. R PL. 0 MVE.
❑ M.H. 0 POOL
Sto
GAS
DF$CRIBE WORK-
VALUATION
9.
Source
of
Utilities
E
Split Entry
No. Baths
Split Level
No. Floors
No. Rooms
Rancher
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
4he«
E CTRIC../] 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 pr the
performance of construction.
DATE
DEPT.
SPECIALAPPROVALS-
REQ'D. REC'D.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
OATE�OFFICIAJR QAAA/NSW \
APPROVED FOR ISSUANCE
-FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL .$ja 11°
04* *1200
*.1200 N
*12006
E -*000 3
2027a
03-11-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES /iiPERMIT.
0 5:JF-8"0'
•
20282 *"120.0O.f-