1980, 08-19 Permit: G80-8721 FurnacePLAN 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 3 COPIES
JOB ADDRESS
1.
7q
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
PARCEL N,lJMBERdS
OWNER
3.N�ADDRESS
CONTRACT)3.12
/ r
+erZ4," Atl �l�L
4.
PHONE
' - <Z/4
ADDRESS
/3z‘71 zt/.1sX
DESIGNER
5' ADDRESS
ZIP
PHONE
Actual Set Backs in Feet
North 'South East (West
Size of Parcel 1 Zone Classification
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
Valuation 1 Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
gerNEW
0 BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
gr MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.7. r�
VAL ATION SOURC
OF
9. UTILITIES
ELECTRIC
WATER
SEWER
Enum. Dist.
Ownership
Public ❑ Private 0
Location (Area)
USE CODE
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 or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATIONrA SIGNATURE OF APPLICAN
�(pvv
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
/ . T
cia J 1
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
3
Single $
Building
Plumbing Q
Mech.
1
Plan Check
SEPA
Mobile Home
Other (Specify)
Ara
TOTAL $
PERMIT NUMBER
04* *1200
* 1200
* 12.006
*0.00
8720
08-19-80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0:841 8,72,1° '*12.002.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL