1980, 01-11 Permit: 80-77 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT &' c6 jj r -11/
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE —4 Eo
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 6- * * 9,0 0
JOB ADDR S
s-05" IJ! / ch r LEGAL DESCRIPTION - SEE ATTACHED * 9.0 0 tii
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 9 0 0
2.
OWNER -� PIAIDNE E * G,0 0 O
3. • x.4)(.1 CAA-6U) ` 0(F— ," 7.6 2
ADDRESS ZIP Required Set Backs in Feet
i' J North 1South East (West 0 1 – 1 1 –c3 0
CONTRA OR � PHONE Size of Parcel Zone Classification
4. ADDRES ` j Z} �/,1/���/. Type Const. Occupancy Sprinklered
-09— +A a4-,,0%:-� / -! � i
Oyes ❑No ❑ Req'd. 0 4 * * 3 0 0
DESIGNER PHONE Valuation Building Area in Sq. Ft.
* 3. 0O T)
5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage * 3. 0 0 r
CHANGE OF USE FROM TO Split Entry Split Level Rancher E 8 * 0 0 C E i
6.
No. Baths No. Floors No. Rooms Rec. Room 7' c
TYPE ❑ NEW 0 ALT. 0 AD'N. ❑ RPL. 0 MVE.
7. OF ❑ OTHER - 0'1 - 1 1 80
WORK
0 BLD. 0 PLMB. ❑ MECH. 0 M.H. ElPOOL CERTIFICATE Req'd. Rec'd. Not Req'd. .
of EXEMPTION 6 4 7 9,
DESCRIBE WORKGG
8 LS f AZ1c, i _ /60
6f1or 67--(1 FEES COLLECTED
VALUATION Source ( ELECTRIC WATER SEWER
of
9. Utilities XA
Single $ —
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 otherstate r local law regula ' g construction or the
Plumbing
performance of constr ction.
J
DATE )� � \
� � SIGNATURE_ Z r Mech.
.D
SPECIAL APPROVALS SPECIAL O DITIONS: 1� 00
DEPT. REQ'D. REC'D. Plan Check lL'
Env.Health (!I— aO /
r.�
I �f" l SEPA J
PI,nninn /li1 - ' — tip.
Mobile Home U)
Fire Marshall —
Co. Engineer I'MLL Other(Specif
2_0211- ttakta
Utilities a..s a
TOTAL $ e •w
Zone Clearance
, WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT. - .7 '1/$ 0 r', 0 �y i-
DATE I—)1-53C OFFICIAL O A4L 2' �.. '' '- -
I. Cr("y( )
APPROVED FOR ISSUANCE �` –