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1980, 01-08 Permit: 80A-9899 FurnacePLAN NUMBER APPLICATION/ PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 �V PERMIT V v� NUMBER � DATE VALUATION Source GAS ELE7CTRIC WATER SEWER of 9. utilities Single $ I 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 SIGNATURE— Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. RECD. C'1 Plan Check Env. Health {\�J SEPA Planning Fire Marshall Mobile Home Co. Engineer It./VI 000 [ Tj �VI i�+ J Other (Specify) Utilities u 1 TOTAL $ Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist THIS BECOMES A PERMIT. Q CST , DATE D' UV OFF[( -IA CL' CZ.N\JVA r(, -A q APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES JOB ADDR S LEGAL DESCRIPTION — SEE ATTACHED 1 LOT BL CK D ISI N PARCEL NUMBER/S 2. I OWNER PHONE 3. ADDRESS ZIP Required Set Backs in Feet North South East West CONTR T R PHONE Size of Parcel Zone Classification 4' AD R SS ZIP Type Const. Occupancy Sprinklered fflry T ❑Yes []No ❑ Req'd. DESIG ER 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 El 1:1 ALT. ❑ AD'N. ❑ RPL. ❑ MVE. No. Baths No. Floors No. Rooms Rec. Room 7, OF El BLD. 1-1PLMB. 11MECH: ElM.H. El POOL POOL CERTIFICATE Req'd. Recd. Not Req'd. WORK of EXEMPTION I DESCRIBE WORK 8 FEES COLLECTED �V PERMIT V v� NUMBER � DATE VALUATION Source GAS ELE7CTRIC WATER SEWER of 9. utilities Single $ I 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 SIGNATURE— Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. RECD. C'1 Plan Check Env. Health {\�J SEPA Planning Fire Marshall Mobile Home Co. Engineer It./VI 000 [ Tj �VI i�+ J Other (Specify) Utilities u 1 TOTAL $ Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist THIS BECOMES A PERMIT. Q CST , DATE D' UV OFF[( -IA CL' CZ.N\JVA r(, -A q