HomeMy WebLinkAbout1980, 01-31 Permit: 80-757 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
1.
2.
JOB ADDRESS
'!j'' 1 /` �//
LOT BL CK SUED VI ON ," '/ � �
•-LEGAL DESCRIPTION — SEE ATTACHED
OWNER
3. 13JJ-L 1D EY
ADDRESS
PHONE
y -.x 3 f
ZIP
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South lEast 'West
CONTRACTOR
a. /\1 C•D ,,4T/No
C, G
ADDRESS
o .�� T R 1/J r
DESIGNER
5' ADDRESS
PHONE
s-917..
Size of Parcel I Zone Classification
ZIP
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
Valuation (Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area Garage Area
6.
CHANGE OF USE FROM
TO
Split Entry
Split Level
Storage
Rancher
TYPE
7, OF
WORK
❑ NEW
❑ BLD.
❑ ALT. HI AD'N. 0 RPL.
❑ PLMB. I MECH: 0 M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK s
8.
VALUATION Source G S ELECTRIC WATE SEWER
of
9. Utilities
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 SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE F.31-19/OFFICIAL
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
7 o--�„
DATE
PERMIT NUMBER
)/�
L.
*7.00
*7.00
*7.006
E *0.00 n
7562
01-31-80
6479.
APPROVED FOR ISSUANCE
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
77,7 *7.0.021