1980, 01-09 Permit: 80A-9975 Furnace PLAN NUMBER APPLICATION/PERMIT # M PERMIT NUMBERg1` g I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 4 * *7,0 0
JOB ADDRESS
\J
t ' LEGAL DESCRIPTION - SEE ATTACHED * 7.0 0 N
1.
LOT BLOCK SUB'DTISIO PARCEL NUMBER/S * 7.0 0 4
2. cD
OWNER,, ^^�� PHONE E * O.0 O U
3. W CL1U14rn. SZA )v QQ . ZI Z$- I lie(0 9 9 7, 4 2
ADDRESS ZIP Required Set Backs in Feet
C),/Vy`� North 'South East 'West 0 1 -0 9-8 0
CONTRACTOR PHONE Size of Parcel Zone Classification
4. f7l.C—IQ a
SLI- y9Z5 2 6.479.
ADDRES 1 ZIP F� Type Const. Occupancy Sprinklered
C 5® c l 7_ _ 4 (riot ZV 6 Oyes ❑No ❑ Req'd.
DESIGNER ��LN�� PHONEIValuation 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
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. c Q9, `I 1 pii,ovva_0_ FEES COLLECTED
VALUATION Source GAS ELECWATER SEWER
of
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 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. Plumbing
DATE SIGNATURE_ Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health cc
SEPA o
Planning _ U
o_
Mobile Home cr)
Fire Marshall
Co. Engineer Other (Specify)
Utilities ►''7 o 7
TOTAL $ F
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist ((����+ =y� THIS BECOMES A PERMIT.
DATE i—`1 OFFICIAL 1.-MM.RWs, i - y � -
APPROVED FOR ISSUANCE _