1980, 07-01 Permit: 80-6553 FurnaceA
.LAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
2.
3.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
5. /26/4 1/44co S/w,s/
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWNER
JCRRY /jrie/i✓
ADDRESS
PHONE
928 664o
ZI P
CONTRACTOR
4. %/pn/tE 445.9 ,U4
ADDRESS
a. /04'09rk
DESIGNER
5 ADDRESS
PHONE
Q2 ,-ziB7
Actual Set Backs in Feet
North "South East (West
Size of Parcel Zone Classification
ZIP
45G
Type Const.
Occupancy Sprinklered
Des ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
i 'NEW 0 ALT.,❑y�AD'N. 0 RPL. ❑ MVE.
CJ
0 BLD. ❑ PLMB. MECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8 -yes 1i.evm
VALUATION
9.
SOURCE
OF
UTILITIES
Sn, coo ,a -r4
GAS
ELECTRIC
Enum. Dist. 1 Location (Area)
WATER
SEWER
Ownership
Public ❑ Private 0
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
SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. /244,0
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /2`e�
PERMIT NUMBER
--65 3
04* *1200
*1200
*12006
B *0.00
6552
07-01-80
2 6479.
0
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0101`-80 655.32
DATE ISSUED PERMIT NO.
*12.00°1
TOTAL