1980, 09-12 Permit: 80B-97 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 ADDRESS
1.
13322 East 5th
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3.
OWNER
Jerry Knowles
PHONE
924-8898
PARCEL NUMBER/S
ADDRESS
13322 East AX 5th
ZI P
CONTRACTOR
4. ADDRESS
Valley Fireplace, Inc_
E. 16610 Sprague Ave.
PHONE
922-2780
Required Set Backs in Feet
North (South East 'West
Size of Parcel Zone Classification
ZI P
99037
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
rJ. ADDRESS
6.
TYPE
7, OF
WORK
Veradale,
PHONE
Valuation
Building Area in Sq. Ft.
Contractor Specialty
No_ VA LL rF 526 Obi
CHANGE OF USE FROM TO
ZI P
DWL Area I Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
❑ NEW ❑ ALT. 0 AD'N. ❑ RPL. ❑ MVE.
0 BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
E OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.
Install "Johnson " Add A Furnace
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
Dn 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 other state or local law regulI ting c
performance of constructio
DATE L-� G' SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
nstruction or the
SPECIAL CONDITIONS:
Ready for inspection
DATE OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
p41
Single $ U • " J
Building
Plumbing
Mech. GnJ
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ 9C
DATE
m
PERMIT NUMBER
a.t3-q7
9/10/80
04*
A
*7.00
*7.00 17)
*7.006
*000 E
9.4
09-12-80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
--1 2 —
9, 7 z