1980, 05-28 Permit: 80-5073 FurnacePLAN NUMBER APPLICAT:JN/PERMIT
PERMIT NUMBER
-fA'
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
c_
DATE �',
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
0 4 * *700
*7.00 n
JOB ADDRESS
-)LG
LEGAL DESCRIPTION - SEE ATTACHED
1. 5 / Lr -d, -,*7,00
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
E *000 n
507.22
OWNER
�, ��
PHONE
3.
O
05-28- V 0
ADDRESS 7✓
ZIP
Required Set Backs in Feet
North South East West
6,479,
CONTRACTOR
ONE
Size of Parcel
Zone Classification
�j-
4' ADDRESS �..,
ZIP
Type Const.
Occupancy
Sprinklered
�.,. OA
❑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.
TYPE ,NEW El ALT. ElAD'N. 11 RPL. ElMVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF ❑ OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
El BLD. ❑ PLMB. ®. MECH: ElM.H. ❑ POOL
WORK
of EXEMPTION
DESCRIBE WORK
FEES COLLECTED
$ �
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
9.
of
Utilities
iL
Single $
—
Ihereby certify that I have read and examined this application and have read the "NOTICE" provisions inc]ed
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governinBuilding
type of work will be complied with whether specified herein or not. The granting of a permit does not preto
give authority to violate or cancel the provisions of any other state or local law regulating construction operformance
of constructiion. Plumbing
DATE l Z�S SIGNATURE %N�2Y.f1 lJ�k�Mech. c
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
—
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
IN THIS SPACE,
WHEN MACHINE VALIDATED
SEPA Checklist THIS BECOMES A PERMIT.
7 n
507,325 * 1. 0 U F-
DAT EFFICIAL
Q.