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1980, 01-21 Permit: 80-388 FurnacePLAN NUMBER i APPLICATION/ PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 ',VAI PERMIT NUMBER Q i \ V © SJ� DATE C U * * 1� 0 Y c: 0 38.72= 0 –L ,': 6479. DESCRIBE WORK LU _– ��'_ FEES COLLECTED VALUATION Source GAS ELECTRIC WATER SEWER Of XXX , X Y 9. utilities n /� Single $ APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included JOB ADDRESS type of work will be complied with whether specified herein or not. The granting of a permit does not presume LEGAL DESCRIPTION — SEE ATTACHED 1. h . 50 —_ Plumbing performance of construction. DATE �� –8–L' SIGNATURE �— �, C; �� Mech. � ctl LOT BLOCK SUBDIVISION Env. Health PARCEL NUMBER/S 2. I Fire Marshall Mobile Home � Co. Engineer Other (Specify) OWNER TOTAL $ PHONE Zone Clearance 3.v WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist THIS BECOMES A PERMIT. 1� _ a+_�OFFICIAL 0�' �' �= 7.'�i ADDRESS �� - ZIP Required Set Backs in Feet n K.. � I 4 `1�L� North South East West CONTRACTOR PHONESize of Parcel Zone Classification 4' ADDRESS �_ ZIP Type ConiTj Occupancy Sprinklered 3 L�ti e� ❑Yes ❑No ❑ Req'd. DESIGNER PHONE Valuation Building Area in Sq. Ft. 5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage CHANGE OF USE FROM TO Split Entry Split Level Rancher 6. No. Baths No. Floors No. Rooms Rec. Room TYPE � NEW El ALT. 1-1 AD'N. El RPL. ❑ MVE. 7, OFElOTHER 11BLD. 1:1n PLMB. MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd. WORK ""l of EXEMPTION I ',VAI PERMIT NUMBER Q i \ V © SJ� DATE C U * * 1� 0 Y c: 0 38.72= 0 –L ,': 6479. DESCRIBE WORK LU _– ��'_ FEES COLLECTED VALUATION Source GAS ELECTRIC WATER SEWER Of XXX , X Y 9. utilities n /� 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 regulating construction or the Plumbing performance of construction. DATE �� –8–L' SIGNATURE �— �, C; �� Mech. � ctl SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. REC'D. Plan Check Env. Health SEPA Planning Fire Marshall Mobile Home � Co. Engineer Other (Specify) Utilities L TOTAL $ Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist THIS BECOMES A PERMIT. 1� _ a+_�OFFICIAL 0�' �' �= 7.'�i DATEi W�VY�.Z71A. �� -