1980, 09-16 Permit: 80B-289 FurnacePLAN NUMBER
a
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
`-11 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
Job ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK BDI I UP PARCEL NUMBER/S
2.
OWNER PHONE
3. d''- , / / a ,v 5'- - c
ADDRESS I
C ZIP Actual Set Backs in Feet
LcYYP 6yt /c ✓t�i`4 4/.2 9 L`.;t / North South East West
CONTRACTOR PHONE Size of Parcel Zone Classification
/-1 6)i, i% / r, r -OZ /UC7
4. ADDRESS / ZIP Type Const. Occupancy Sprinklered
/ 71a 1✓w f, S s2 C �;, Dyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPE❑ NEW ❑ ALT. ❑ AD'
No. Baths No. Stories No. Rooms No. of Dwellings
N. ❑ RPL. ❑ MVE.
7 OF WORK 11 BLD. 1:1PLMB. 1:1MECH. ElM.H. 13 POOL 1-1 OTHER CERTIFICATE Req'd. I Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area)
FEES COLLECTED
/2/G
VALUATION I SOURCE GAS ELECTRIC WATER SEWER
OF Ownership USE CODE
9. UTILITIES 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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
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
DATE OF APPLICATION 9 SIGNATURE OF APPLICANTs--wn--2 -� Mech. 3, c'y
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
s Examiner
Building
PERMIT IS NONTRANSFERABLE
91 41141
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ �7, G-1 C✓
WHEN MACHINE VALIDA7
THIS BECOMES A PERMIT.
141 PERMIT NUMBER
SO CS - 28g2
04* *7.00
* 7,C0
*700
A *0.00
2 7. 8
09-16-80
6.479,
E,
18.92 Z00°I-