1980, 10-22 Permit: 80B-2450 FurnacePLAN NUMBER
Ci
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.
LOT
BLOCK
C - i,'L;O, l/ c; topt
SUBDIV ION
2.
OWNER
3. 39/e,e . L AI . ; //AA
ADDRE
CONT CTOR
4. ADt)
LEGAL DESCRIPTION — SEE ATTACHED
PI-ZONE
PARCEL NUMBER/S
ZI P
5.
DESIGNER
PHONE.
Actual Set Backs in Feet
North 'South LEast IWest
Size of Parcel 1 Zone Classification
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No D Req'd.
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
8.
9.
❑ NEW
❑ BLD.
DESCRIBE WORK
VALUATION
❑ ALT. ❑ AD'N. ❑ RPL. D MVE.
O PLMB. .fi ECH. ❑ M.H. ❑ POOL
SOU RCE
OF
UTILITIES
GAS
x
ELECTRIC
0 OTHER
461,2,4-et-ael •
WATER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private ❑
Req'd.
Rec'd.
Not Req'd.
Location (Area) FEES COLLECTED
USE CODE
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
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
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B (ding Technician
SPECIAL CONDITIONS:
/01S" 000 era.
• / If
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /47°0
PERMIT NUMBER
» 245
04*
* 14.00
* 1400
* 14.006
*000
244.9f
10-22-80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
7 0 42 '2' 8:O.
DATE ISSUED
4'
PERMIT N� 5 O