1980, 06-13 Permit: 80-5770 FurnacePLAN NUMBER APPLICATION/ PERMIT
PERMIT NUMBER
S
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
C
JOB ADDRESS v
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVI ION
PARCEL NUMBER/S
2.
I
OWNER
PHONE
3.�
( -'
ADDRESS n
ZIP
Required Set Backs in Feet
S ' �-�-) �&--1Li-
LJ
North South East West
..
CONTRACTOR /1
PHONE
Size of Parcel
Zone Classification
i -lam_-�.�-<-�"---�,5�_
') Z � Z S-t—-1t�.
j (i
4' ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
<�-��� 1'
i j�—U (p
❑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 ❑ALT. 11AD'N. El RPL. 1-1MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OFp\� -- ElOTHER
1:1BLD. ❑ PLMB. -L�.JVIECH: ElM.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK FEES COLLECTED
VALUATION
So7rce,
GAS
ELECTRIC
WATER
SEWER
9.
Ut
Single $
1 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 Building
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
Plumbing
performance of construction.
DATE lv 1 SIGNATURE—
Mech.^ti
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
i
Co. Engineer Other (Specify)
Utilities
TOTAL $.�
Zone Clearance -
WHEN MACHINE VALIDATED
IN THIS SPACE
THIS
SEPA Checklist �,,.�,� j BECOMES A PERMIT.
(/y(
DATE FFICIAL a-AA�\
�1