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1980, 04-23 Permit: 80-3849 FurancePLAN 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 4 COPIES JOB ADDRESS � . �S X1'1 LEGAL DESCRIPTION - SEE ATTACHED 1. t,C�..- LOT BLOCK SUBDIVISION PARCEL NUMBER/S z. _ OWNER PHONE ( — 3 ADDRESS ZIP Required Set Backs in Feet �� �S .�- �:�, !� North South East West CONTRACTOR -� PHONE Size of Parcel Zone Classification 4. ADDRESS ZIP Type Const. Occupancy Sprinklered ❑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. No. Baths No. Floors No. Rooms Rec. Room TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7, OF El OTHER 1:1 BLD. ❑ PLMB.MECH: 1-1M.H. El POOL CERTIFICATE Req'd. Recd. Not Re q'd. WORK of EXEMPTION DESCRIBE WORK 8 G K uli 0� FEES COLLECTED VALUATION Source GAS ELECTRIC WATER SEWER of 9. utilities 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 performance of construction. Plumbing DATE — L9 SIGNATUREI Mech. CJ SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. REC'D. Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist nn-rF��/ a nFFirini Plan Check SEPA Mobile Home Other (�Specify)- TOTAL $ 1 • 1-3—() PERMIT NUMBER DATE p. 7 ., 0 *; o, r <, 384.8 G4-23-88 6.4 7 9, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BFC OMES A ERMIT.