1980, 05-23 Permit: 80-4953 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
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 n
JOB ADDRESS G4 * * 9,00
1. /,?.._(, z) ._ -. �ie� A/D LEGAL DESCRIPTION - SEE ATTACHED * �i o o
LOTBLOCK SUBDIVISION PARCEL NUMBER/S
2. * 9: 00
0, I'ER PHONE ✓ 4
3. iGfe/b9—,esn _,..5":&--A/7-LE-,e...,_,..5":&--A/7-LE-,e..., 1.291-e1, 7'l'.9E V C:
ADDRESS ZIP /;/ Required Set Backs in Feet 4 9 5 2:-
,, ,e/11 jfZi North 'South East 'West
CONTRACTOR PHONE Size of Parcel Zone Classification 0 5-2 3-8 0
4. /v//vte: / G/eA er 4 /. ,, ,-A/e- 535-/l// 6 4 7 9,
A/R �7 / / / �/.�1 5/1„,.. .0„.4,. .. �31p�; Type Const. Occupancy Sprinklered
ASV /v� /7��,G� '7f'T- Z/ % �}Z ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area I 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 ❑ OTHER
WORK ❑ BLD. Cl PLMB. 1NECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK FEES COLLECTED
VALUATION Source GAS ELECTRIC 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 -5 - /.- .7y ..C , •- 1 - I . '7' .-e‘- Mech. / ., /,
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA o
Planning — C.
0
Mobile Home cn
Fire Marshall z
Co. Engineer Other(Specify)
Utilities 9616)
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
01 ` - 9, 00 ° �
iii,.;, - DATE S/OFFICIAL 05 , 3 -` 8'0 49 5. J 5.
APPROVED FOR ISSUANCE _