1980, 09-19 Permit: 80B-561 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
LOT
2.
BLOCK
' /i3. T 4500) e �
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
OWNS �/
3, nfjP,e-f- 1144 Sr/Nit-5
AD DRE$$
4.
5.
CONT R.44tT� 1/ 1 --)Re
re `e' e4 &jodK
AD
DESIGNER
PHONE
,�aEas �a
ZIP
ci'a?O�'
PARCEL NUMBER/5
Actual Set Backs in Feet
North i 'South -
East
West
PHONE
PHONE
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered,
❑Ves ❑No 0 Req'd.
Valuation 1 Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
8.
9.
'❑ NEW
❑ BLD.
DESCRIBE WORK
h
VALUATION
❑ ALT. 0 AO N. 0 RPL. ❑ MVE.
❑ PLMB. (Ijl MECH. 0 M.H. 0 POOL
0 OTHER
SOURCE
OF
UTILITIES
GAS
Istd'
ELECTRIC
WATER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Location (Area)
Ownership
Public 0 Private ❑
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 APPLICATION
SIGNATURE OF APPLICANT
Req'd.
SPECIAL APPROVALS
' NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
' Building Technician
SPECIAL CONDITIONS:
/D.S,00d C7ZL .
301
PERMIT IS NONTRANSFERABLE
Recd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /47 0
PERMIT NUMBER
&0t3— S(o/
04* *1400
*,1&00
*14006
A *0.00 S
560
0'9-19-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
019`r11'91;`8,V
PERMIT EXPIRES ONE NEAR FROM DATE OF ISSUANCE DATE ISSUED
/6,1z *1,4002P.
PERMIT NO. TOTAL