1980, 04-03 Permit: G80-3061 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB
LOT
2.
ADDRESS
Imo -
LEGAL DESCRIPTION - SEE ATTACHED
BLOCK
SUBDIVISION
3.
OWNER
ADDRESS
PHONE/
ZI P
PARCEL NUMBER/S
Required Set Backs in Feet
North (South
East
West
CONTRALTO
u;L Neati jn c
4. ADDRESS
PHONE Size of Parcel
5"=3I S—
7
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
- 8.
9.
❑ NEW
❑ BLD.
DESCRIBE WO
VALUATION
❑ ALT.
O PLMB.
AD'N. 0 RPL.
I(RMECH: ❑ M.H.
O MVE.
O POOL
0 OTHER
Source
of
Utilities
ELECTRIC
No. Baths
No. Floors
No. Rooms
Rec. Room
WATER
CERTIFICATE
of EXEMPTION
SEWER
Req'd.
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 of spate or local la egulating construction or the
performance of construction.
�
DATE "fL"-. '"9°
SIGNATUR
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECI ' ONDITIONS:
DATEL
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
500
Plan Check
Ju
SEPA
Mobile Home
Other (Specify)
PERMITJHJMBEIR
50 -soul
DATE 4 -2O
0 * *20.00
• 2 0 ') 0u;
* 20.00Y
L
E *(`,00
30602
0 -C3-80
6479.
TOTAL $;:20.00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. n
0 A
56,1T *20.00°
INSPFri: R