1980, 07-01 Permit: 80-6554 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 BLOCK
2.
SUBDIVISION
3.
OWNER
met. LOJ,4cc.
PHONE
928 -0,90
L�'GAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
ADDRESS
5 Roq /?9c C»v14c p,)
ZIP .
49zi6
Actual Set Backs In Feet
North 'South
East
'West
CONTRACTOR
4. ij, the /irst7�
ADDRESS
G 104108 9r
PHONE 7097
9tfa --
Size of Parcel
Zone Classification
ZIP
99toc-
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
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
DESCRIBE WORK
8.
VALUATION
IA NEW
❑ BLD.
❑'ALT.
❑ PLMB.
❑,( AD N. 0 RPL. ❑ MVE.
G MECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
6A5 t4/?.lrgcCf
80, azo /S7u
Enum. Dist.
Location (Area)
9. •
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
I hereby certify that 1 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 7— r r gv
SIGNATURE OF APPLICANT_A '
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B tli Technician
070,
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. • J'jaSo
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 12.0e
PERMIT NUMBER
C.JL�
04* *1200
*1200
*12006
B *^00
6551x•
67-01-80
g 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0r71;-40;iiL4810
DATE ISSUED
65'15,42 *120012.1
TOTAL
PERMIT NO.