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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-