1980, 12-22 Permit: 80B-5122 Furnace, PipingSize of Parcel
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. E.`73O
LOT
2.
BLO K
-7T ti
SUBDIVISION
OWNER
3. -‘)E L.2,6'F i .5 M )1"-t4
ADDRESS
.T 303
Til
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
ZIP
Actual Set Backs in Feet
1South East
North
CONTRACTOR
4. AAA. i4is ATt.ix) 61
ADDRESS
[Pet.
PHONE
Ctza:-7
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
ZIP
PHONE
ZIP
Type Const.
Occupancy
Valuation
West
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
Main Floor Upper Floors Garage Area 1 Storage
Area of Decks
Finished Basement Unfin. Basement
KNEW ❑ ALT. 0 AD'N. D RPL. 0 MVE.
0 BLD. 0 PLMB. EK4EcH. 0 M.H. 0 POOL
No. Baths
No. Stories
No. Rooms
❑ OTHER
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIBE WORK
8. QAJAC.E
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
Fe Pe
Enum. Dist. I Location (Area)
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private 0
USE CODE
1 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 autho.tty to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT ONS orDATE OF APPLICATION /` >7 1
9 — 7 SIGNATURE OF APPLICAN [r/i16./
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building T chni iiaann1
SPECIAL CONDITIONS:
" — 2c
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. #12..
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
-ji'EIX'd1r1T NUMBER
r
8nt3'�IzZ
04* *1200
*12.00 r
*12006
A *000 8
51218
12-22-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•i
12(:t'2 2'71 bi
DATE ISSUED
512.2i *1Z00
PERMIT NO. TOTAi