1980, 12-17 Permit: G80B-4949 FurnacePLAN NUMBER
oy
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. •7 3
LOT
to 7-4
LEGAL DESC
IPTIOMN — SEE ATTACHED
BLOCK
2.
OWNER
3. ✓ / /.?�J
ADDRESS
4.
5.
SUBDIVISION
ESS
/ 3-72S (�' /lo�'�( rW
DESIGNER
PHONE
.ay - oss3
ZI P
PHONE
ZIP
>99,2o.6
PHONE
PARCEL NUMBER/S
Actual Set Backs in Feet
North South
Size of Parcel
Type Const.
Occupancy
East
West
Zone Classification
Sprinklered
Oyes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
O MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE
8.
VA
9.
ORK
ON SOURCE
OF
UTILITIES
ELECTRIC
WATER
SEWER
Enum. Dist.
Ownership
Public ❑ Private ❑
Location (Area)
USE CODE
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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
/A4 %6a d
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
rUKO f't--/2J-)
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /Pti
-
PERMIT NUMBER
04* *12,00
* 12,00 N
* 12006
A *000
494,82
12-17-80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12i�.17-8`0
DATE ISSUED
49492 *1200x1---
PERMIT NO. TOTAL