1980, 05-19 Permit: 80-4909 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
J C! ADDRESS"/
1. 9
H i// /
LOT BLOCK SUBDIVISION
2.
O
LEGAL DESCRIPTION - SEE ATTACHED
ER _
3. ,t 78t e7/i 9 /Y1 //.S/
ADDRESS
R _Wm NToma_R /4/L )//1/,
' ADDRESS
At /,2 • ,macG,� V4
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East (West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
Lives ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation (Building Area in Sq. Ft.
ZIP
DWL Area Basement Area r Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ PLMB. MECH: ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
9.
DESCRIBE WORK
te5i4.44-e4- L'/G�,Ci,c,i�✓t%L' �/ii/v t�d�' /D5 / 2 'c
WATER
VALUATION
Source
of
Utilities
GAS
ELECTRIC
g 77d.
SEWER
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
DATE 67-1 - SIGNATURE1/
DEPT_
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
HOME OWNER'S WARRANTY
YE 0
#D L7
SPECIAL CONDITIONS:
DATE
•
FFICIAL C1AA.1Y1�
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
//. 47
TOTAL $ /tae)
PERMIT NUMBER
'w—moa
DATE
64* * 1 1.00
* 1 1,00 17,
* 1 1.006
E *0,00
490,8
05-19-80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOME,$ A P. E,RMIT. o
0'5; 1,) 4 9'0.92
*11.00