1980, 04-01 Permit: 80-3381 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT M-4530—33(6,
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE A-- 2
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
04 * * 7, 00
JOB ADDRESS
t -73._.-73._.I —1 1 t!`
1 1 LEGAL DESCRIPTION — SEE ATTACHED * 7- 0 0 t5
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 7, n 0
2 OWNER PHONE E '' n 0 0
3. q / 33 33 .0
ADDRESS ZIP Required Set Backs in Feet
I `1 .- North 'SouthEast (West 0 4— 1 1 —8 0
CONTRACTOR PHONE Size of Parcel Zone Classification
4. ""`-- `'0`..(-� 1 2-- - ?--), aA.4 7 9.
ADDRESS. _ IP Type Const. Occupancy Sprinklered
1 - Cj 3(_, �` )1....Q��� � 1.0 CQ ❑Yes ❑No ❑ Req'd.
DESIGNER J PHONE Valuation Building 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.
TYPE No. Baths No. Floors No. Rooms Rec. Room
NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ,KMECH: 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities X, >C
Single $ —
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 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.tiPlumbing
DATE 1 Cv SIGNATURE : _ . _ _ –\'s41,.0t^` Mech. 1 .0 U
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA O
Planning — U
w
2
Mobile Home c,"
Fire Marshall
Co. Engineer Other(Specify)
Utilities TOTAL $ '"----?'c'' U
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
DATEh///07O OFFICIAL e{A/1✓L✓4...- rL. U 4r-1.'1 —0 '0l .% i 8. 1 z *7. 0 0 0. it
APPROVED FOR ISSUANCE —