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.