1980, 11-21 Permit: 80B-4050 FurnacePLAN NUMBER APPLICATION/PERMIT)n
, PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS
HARD TO MAKE 3 COPIES
L� * * 1 4,
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
-I
1 ,�
LOT
BLOCK
S I N
PARCEL NUMBER/S
2.
* 1 4,00Y.
O ER
PHONE
3..3-1�'
U 4 9 ,=
ADDRESS I
ZIP
Actual Set Backs in Feet
�61
orth South East West
1 1 C 1 -
C TR CTOR
PHONE
Zone Classification
Size of Parcel
Jr
4
4. ApDRES
%
IP
Type Const.
Occupancy
Sprinklered
112 ZE
L% %
[-]Yes❑No 1:1Req'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.
I
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. 1:1MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
7, OF ❑ OTHER
CERTIFICATE
Req'd.
I Recd.
Not Req'd.
WORK ❑ BLD. ❑ PLMB. D4 MECH. ❑ M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK
Enum. Dist.
Location (Area)
s. / / R , oao
FEES COLLECTED
VALUATI SO RCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public El Private ❑
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 mit does n presume Building
to give authority to violate or cancel the provisions of any other state or local law re Ing cons on or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION Plumbi g
Z� � �
DATE OF APPLICATION SIGNATURE OF APPLICANT ch.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
%f
Env. Health �
��,
Planning SEPA � !d ,.,��
i+hJ
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTAL $� '--
Plans Examiner
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
6 1d�g�il�ichFlician PERMIT IS NONTRANSFERABLE �, « �,�'.'$ �.
4 0.kQ 2' *.1 �.0 0 -J _
f .. '