1980, 08-11 Permit: 80-8362 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
1.
2.
3
JOB ADDRESS AA
//941. ,4fett tJ e //
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
1,-/A
ADDRESS?WV .0 ATE. 'rt'
PHONE
Ft- 7909
/9Z
P
/ r10`
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South
East
I W est'
4.
5.
CON�TT..R.ACTOR J p
RESS
ADO /I.S'z J /[/ /irk'
DESIGNER
ADDRESS
Size of Parcel
/
Zone Classification.
ZIP
`%4720/
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ONo 0 Req'd.
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks .
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
*NEW 0 ALT. 0 AD N. 0 RPL.
�l0 BLD. 0 PLMB. AS MECH. 0 M.H.
0 MVE.
0 OTHER
0 POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION • .
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.Z n //), .i flce
VALUATION
9.
SOURCE
OF
UTILITIES
ELECTRIC
WATER 1
SEWER
Enum. Dist.
Location (Areal
Ownership
Public 0 Private 0
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 "' grL-/
SIGNATURE OF APPLICANT
c4L—atU%�JVft
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checkl
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
. /r"
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
C
TOTAL $ f —O
1
j9ER!bFz NUMBER
PO -8362-
04* *laoo
*,la00 63
*1x006
A *000 1.3
83612
08`-11-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
14;'rliFllY 81;0'
DATE ISSUED
8;31622
PERMIT NO.
•
18.00°' —
TOTAL