1980, 05-10 Permit: 80-4628 Furnace, Heat Pump PLAN NUMBER APPLICATION/PERMITPERMIT NUMBER I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT MSO` 11(44
Is, NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE -.S/Vec-t)
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
1 13.00
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED ! i i
1. 1/55 2 S0 ,14-r,e-r•-_4"1
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 : 0 0
2. ,..
L:. 0 0
,
OWNER �� ,i -i /> PHONE
Required3. 4 E., 7
Set Backs in Feet
ADDRESS ZIP
North 'SouthEast West 0 G—' I 0—C=+
CONTRACT R PHONE Size of Parcel Zone Classification
tib, yf/ 733 6 �� c.
4' ADDR S ZIP��11 Type Const. Occupancy Sprinklered
D , fly �7 3 C', 29 ' 1 ❑Yes ❑No ❑ Req'd.
DESIGN 'R J r PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area I Basement Area Garage Area I Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
TYPE No. Baths No. Floors No. Rooms Rec. Room
KNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER -
WORK ❑ BLD. ❑ PLMB. ❑ MECH: 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE W RK
' FEES COLLECTED
8. 4",&t .5 t .c-s.L /------ 4.:. , 447,1- —
VALUATION Source GAS ELECTRIC WATER SEWER
of
_a, 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 cons ruction. Plumbing
�j PW �,
DATE_ c/11 ,C) SIGNATURE y�4 Mech. / r
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT., REQ'D. REC'D. Plan Check
Env.Health
SEPA 2
Planning _ {"j
0
Mobile Home cn
Fire Marshall
Co. Engineer 1 Other (Specify)
Utilities ai,
N. TOTAL $ i3
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. U rl O
1 Ci 2. F
SEPA Checklist �')`� ���(� �� if i Ll 4 8 _ * 1 Q-
DATE�� ' 1 OFFICIAL d QIbIM A; ) /` �"
APPROVED FOR ISSUANCE _