1980, 10-30 Permit: 80B-2947 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 3 COPIES
JOB ADDRESS
LOT
2.
//�/ 24a-ee� `�
BLOCK SUBDIVISION
LEGAL DCSCRIPTION - SEE ATTACHED
OWNER/I
3 C �,c-cmc �SLsc�fir� Rte.
RESS
7/6; /D UCLe2Lrsu
PHONE
/.2
ZIP99�
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South JEast 'West
CONT ACTOR txzo
nor4.
ADDRESS -.
.5-61 3 /c902 dt9
PHONE
Say -97
ZIP
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation )Building Area in Sq. Ft.
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
❑ NEW
D BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. 64,"
VALUATION SOURCE GAS ELECTRIC WATER SEWER
OF
9. UTILITIES
Enum. Dist.
Location (Area)
Ownership
Public D Private ❑
USE CODE
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
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
BIdinh nicjan
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
r/2"7__
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
de
7=
PERMIT NUMBER
SQ,6-297 7
04* *9.00
* 9-00
* 9.006
*C.00
294.62
10-30-80
6479,
•
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-3E780 29472
DATE ISSUED PERMIT NO.
*9.002
TOTAL