1980, 08-04 Permit: 80-8062 Furnace PLAN NUMBER i PERMIT NUMBER
APPLICATION/PERMIT -
SPOKANE COUNTY - BUILOING'CODES DEPARTMENT C .C9 00 .--2—
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
• APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS � / O 4 * * 1 2.O O
1. 57 qz� Ye ve 4, LEGAL DESCRIPTION — SEE ATTACHED * 1 2.0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 2.O O 6
2.
OWNER PHONE
3. .✓'/ S" (0.SC 9. 177r E * 0 0 0 8
U
ADDRESS ZIP Actual Set Backs in Feet 8 0 6 1 2
ref." C"'" North 'South East 'West 0 8_0 4_8 0
CONTR;;IC e� ` B / ��< , ed PHONE-�I Size of Parcel Zone Classification 2S 6 4 7 9
4. ADDR/E`S /4)// // fj4/5-`C)�' /1 ZIP G' Type Const. Occupancy Sprinklered
/�ZY 'v q e, / Dyes ❑No D Req'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.
TYPE KNEW
Baths No. Stories No. Rooms No. of Dwellings
C�rNEW ❑ ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF 0 OTHER -
WORK ❑ BLD. 0 PLMB. •M MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area)
/ I FEES COLLECTED
VALUATION SOURCE ELECTRIC WATER I/ SEWER Ownership USE CODE toe.
OF
9. UTILITIES Public 0 Private 0 Single $ 3
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 Building
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 Plumbing
DATE OF APPLICATION Z'/''' + d SIGNATURE OF APPLICANT i"
' ea-4e"/ ....riot-- Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA
::----
Cl...
Planning I -
r
vire iviarsnaii
Mobile Home "u
U-
Co. Engineer Other(Specify)
Utilities
42°.d
TOTAL $
Xe
•
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
/nician 0 PERMIT IS NONTRANSFERABLE 0i 8 7-0 4 —i8 0 8 0 6. 2 z 1 2. a* a IH-
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL