1980, 01-02 Permit: 80A-9711 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT G �``� �p 9 7//
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE (/� 1 4_6, )17?'
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
1. JOB ADDRESS e ` ( 17a I , ` '� � ^ (�4 * * 2.0 00
((J `C�r,L, iLt,AL DESCRIPTION — SEE ATTACHED * 1 2.0 0 n
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
* 12006.
2. N�
OWNER ,12 irk P9ai� 09 E * 0.0 0 U
3.
ADOREje. o II ZIP Required Set Backs in Feet 9 7 1.0
North 'South East 'West oo
CO `'ALTO PHONE Size of Parcel Zone Classification 0 1 -0 2-V 0
� � �U� fib///�/6�► r___ .
4. A41 DORES / l_ ` ,, --1;� �� Type Const. Occupancy Sprinklered `,_ 6 4 7 9•
�j1 � � > ���0 Oyes ❑No ❑ Req'd.
� OOO����CCJJ
DESIGNER PHONE Valuation 1Building 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. Id AD'N. ❑ RPL. ❑ MVE.
7, OF / ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. IQ MECH: ❑ M.H. ❑ POOL
of EXEMPTION
DESCRI@E WO K
8 �' (///'/�LT/a i-G�� �? �;�l�4 O&O T 4( FEES COLLECTED
LUATION / Sour GAS ELECTRIC WATER SEWER
9. ! ✓ ./ / Uti ities 5ZSingle $
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 per it does not presume
to give authority to violate or cancel the provisions of any other state or al law regula ng construction or the
performance of onstr tion. Plumbing 6 AO
DATE / CZ i9 �� ;.as
SIGNATOR i� �:�.� Mech. uta
PECIAL APPROVALS SPECIAL CONDITIONS: I
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA o
1-
Planning - w
d
Mobile Home
Fire Marshall -
Co. Engineer Other(Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist 6..V
THIS BECOMES A PERMIT.
'd21'4411-1-al �1 '.4j JC-C. ' `l,_ I-.2- 1 d DATE OFFICIAL _, _. _
APPROVED FOR ISSUANCE