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1980, 03-17 Permit: 80-2254 FurnacePLAN NUMBER APPLICATION/ PERMIT 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 JOB ADDRESS 1. C:' D 7 I Loh LEGAL DESCRIPTION —SEE ATTACHED LOT BLOCK SUBDIVISION I PARCEL NUMBER/S 2. OWN R HC 3. ADDj2ES$�M7 ,. CONTRACTOR CONTRACTOR ���, 4' ADD�ESS; �1 4 � DESIGNER L �. ADDRESS CLI-' CHANGE OF USE FROM ITO 6. PHONE `T IP P 4q - X60 ZIP n-2-©r�) PHONE ZIP I vNt [GrNEW ❑ ALT.❑AD'N. ❑ RPL. ❑ MVE. 7. OF WORK ❑ BLD. 1:1PLMB. LFA/MECH: 1-1M.H. El POOL El OTHER DES RIBE WORK s. r i��N1 6� I�� �^1 lid 15 _ 111 2equired Set Backs in Feet Source Borth South East West >ize of Parcel Zone Classification 9, Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. /aluation I Building Area in Sq. Ft. DWL Area Basement Area Garage Area Storage on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing Building type of work will be complied with whether specified herein or not. The granting of a permit does not presto Split Entry Split Level Rancher performance of construction. Plumbing / c) SIGNATURE No. Baths No. Floors No. Rooms I Rec. Room DEPT. REQ'D. RECD. Plan Check CERTIFICATE Req'd. Recd. Not Rec of EXEMPTION SEPA I pipe sizes: r6 FEES COLLECTED VALUATION Source GAS ELECTRIC WATEfl SEWER 9, of Utilities Single $ 1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions inclu]ed on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing Building type of work will be complied with whether specified herein or not. The granting of a permit does not presto give authority to violate or cancel the provisions of any other state or local law regulating construction or performance of construction. Plumbing / c) SIGNATURE DATE Mech. SPECIAL APPROVALS SPECIAL CON IONS: DEPT. REQ'D. RECD. Plan Check Env. Health FOR GAS: SEPA Planning pipe sizes: Mobile Home Fire Marshall pipe length: Co. Engineer Other (Specify) btu's : Utilities Zone Clearance SEPA Checklist C �7 nATF / C1FR1CIA1 l TOTAL $ ^ PERMIT /NUMBER Q 04* 14,0,9 * 1 4, C' E LG 5.3 03-17-80 ;? 6.11 .7 9. WHEN MACHINE VALIDATED IN THIS SPACE, THIS COM A PERMIT. .l" * �T, i, I