1980, 10-27 Permit: 80B-2737 FurnacePLAN 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 3 COPIES
JOB ADDRESS
1.
r� �, I ) `� ,.�'� LEGAL DESCRIPTION -SEE ATTACHED
LOT I BLOCK SUBDIVISION PARCEL NUMBER/S
2. 1
OWNER
3.
ADDRESS
PHONE
`�� � /
`I'1;)! tItf
ZIP Actual Set Backs in Feet
North South
CONTRACTOR n
PHONE t
SZ
Size of Parcel
Zone Classification
4.
4' S
ADDRESS
Z P
� cl
Type Const.
Occupancy
Sprinklered
-0(
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5' ADDRESS
ZIP
Main Floor I Upper
Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
TYPE El NEW El ALT. E-1 AD'N. IN, RPL. El MVE.
7, OF ❑ OTHER
EI BLD ❑ PLMB. �MECH. ❑ M.H. ❑POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
�
8.VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9,
I UTILOITIES
xh
Public ❑Private ❑
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
1A-- %k.l . -H,
Mech.
SPECIAL APPROVALSc I SPECIAL CONDITIONS:
n v. I
lann
Tire iviarsnan
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Techn
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
PERMIT NUMBER
7,(,)Q
C_ / J. 6
1 — 2 % g L
h4'9,
Other (Specify)
TOTAL $ `-
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
h0, ;.;, 2 :. V 2 7 3.7 L
DATE ISSUED PERMIT NO.
k7.0.0°-7'
TOTAL
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