1980, 02-15 Permit: 80-1220 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 Ll
LOT
2.
OWNER
3.
r=
BLOCK SUBDIV- ISION
,LEGAL DESCRIPTION - SEE ATTACHED
ADDRESS
VNTRA..CTOR
4.
.37)-75 Li C'itr/.,,W E-
5.
DESIGNER
ADDRESS
PHONE
A -%C{39
IP
PARCEL NUMBER/S
Required Set Backs in Feet
North (South
lEast
(West
PHONE
CUV
Size of Parcel
Zone Classification
ZIP
cH
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
ZI P
Valuation
DWL Area I Basement Area
Building Area in Sq. Ft.
Garage Area
Storage
CHANG ,O F USE FROM
6. r
TO ` j4-
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
Ir ALT. ❑ AD N. ❑ RPL. D MVE.
❑
PLMB. ❑ M.H. 0 POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. ,U r
VALUATION
9.
Source
of
Utilities
ELECTRIC
WATER
SEWER
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 other state or local law rwulatingAonstruction or the
performance of construction.
`1
DATE / ' SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
5 1" /" Li`
/dam /7 L
DATE i:JLJOFFICIAL. cLAA ""IN-'
APPROVED FOR ISSUANCE
FEES COLLECTED
Single S
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
4VQ
DATE
PERMIT NUMBER
?//-2-7/77
04* *12,00
* 1200 0)
* 12.006
*000
E
121.92
02-15-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS,B C1OM_ESAPERMIT.
62-'1.5-8 0
122,02 *12,00.1