1980, 01-29 Permit: 80-658 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER I
SPOKANE COUNTY - BUILDING CODES DEPARTMENT /1
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE / V-°v
o
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 4 * * 1 2 0 0
JOB ADDRESS ' LEGAL DESCRIPTION — SEE ATTACHED * 1 2.0 0 u)
1. �/ I1/erGf {� 1200
LOT BLOCKK SUBDIVI ON PARCEL NUMBER/S .k
2. C n
OWNER > P ONE E * O. 0 0 U
3. Cl$df� r (d (7lCJ&'" �.3 6 5 7
ADDRESS ZIP Required Set Backs in Feet
a 1),-12-/ 1 North 'South East 'West 0 I =2 9 8 0
CONTRACT R PHONE Size of Parcel Zone Classification
5t O rp , Om`(.t r��`/�/, - ti - 5 4.5/DJ g 6,4 7 9,
4. ADDRESS �J Type Const. Occupancy Sprinklered
Qc Inol(Osi..� 997D7 El yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER Req'd. Recd. Not Req'd.
WORK
III BLD. I=1 PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE
_ of EXEMPTION
DESCRIBE WO i �/ FEES COLLECTED
8. 14-U rJ J 6C---} 400,/O D P�
VALUATION` Source AS EL TRIC WATER SEWERof
—
9. Utilities
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 no granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law r ing construction r the
performance of cons ruction. _ Plumbing
DATE �1--07L` r�U SIGNATURE /2,-4)46
Mech. - j
SPECIAL APPROVALS SPECI C NDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
rY
SEPA `=-
Planning -� ~
CD
Mobile Home cn
Fire Marshall —
Co. Engineer Other(Specify)
Utilities
TOTAL $ '
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA ChecklistTHIS BECOMES A PERMIT.
DATE J� C.J)FFICIAL - G1WN.A,". - y,
APPROVED FOR ISSUANCE -