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1980, 02-21 Permit: 80-1412 Furnace PLAN NUMBER APPLICATION/PERMIT .�;; PERMIT NUMBER lZ I SPOKANE COUNTY — BUILDING CODES DEPARTMENT © — I NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 DATE APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES ' [i. * * 1 1.00 JOB ADDRESS 1. g f <g ; y J / q LEGAL DESCRIPTION - SEE ATTACHED * 1 1. 0 0 s LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 1 0 0 Y 2. O NER / PHONE E * ��' E: c 3. R GL-v R , G /l 6121-.7;z(77 ADDRE ZIP Required Set Backs in Feet 1 4 1. 1 g lam- G{ North 'South East (West 0 2—2 1 —8 0 CONTRACTOR PHONE Size of Parcel Zone Classification p 679. 4. I/O SS_ S �'6F �7 �iEr 531{."'17 7, ADDRESS_ { ZZiP 7 � Type Const. Occupancy Sprinklered �re"/.-2/ fj''e 7-1 C7 ' L' 6 ❑Yes ❑No ❑ Req'd. i DESIGNER 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. No.Baths No. Floors No. Rooms Rec. Room TYPE ❑ NEW ❑ ALT. ❑ AD'N. RPL. 0 MVE. 7, OF 0 OTHER WORK ❑ BLD. 0 PLMB. ❑ MECH: ❑ M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd. of EXEMPTION DESCRIBE WOR/K',/9 $ y•Cat -0.C-4,-it...--7/4_7( .elf /�`� -t�9 C ja,, FEES COLLECTED VALUATION Source GAS ELECTRIC WATER SEWER of 9. Utilities /`77,iteo 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 i to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Plumbing 0 DATE SIGNATURE Mech. I I SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. RECD. (. �X ,w3'' Plan Check Env. Health 1 1 S �y c.,/C SEPA h Planning — w r1_ Mobile Home Fire Marshall Co. Engineer Other (Specify) Utilities TOTAL $ _ Zone Clearance atc-t\Lv\..Axtv.. WHEN MACHINE VALIDATED IN TIt-HIS SPACE, SEPA Checklist n +^�,�, THIS BECOMES A PERMIT. �{DATE ¢a1 '$vOFFICIAL i"{l x i APPROVED FOR ISSUANCE 'f119 L n -0-9. , 1 n '? 1 ri ., 1 1 - _ 1