1980, 02-13 Permit: 80-1146 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT N(�/{ *6)-i/44,
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE 2.-4 "gd
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
(_, 4. * * 1 2 C.
JOB ADDRESS '
1. � /-3 'o4- _ a g- LEGA' -_SCRIPTION — SEE ATTACHED X 11
LOT BLOCK SUBDIVISION PARC'—iaUMBER/S i, 1 h,, ,
2. OWNER PHONE rL U
3. 1:))-....arth.c,Q1 v-if7s- 1 1 p.. 5
ADDRESS ZIP Required Set Backs in Feet
-.....4_4vLw(_e_ 7a.L C North South (J t
East West _— 1 3— _
CONTRALTO /' PHO E Size of Parcel Zone Classification
- )1-i0 114—f- o-tvi=sq 41-8f—fo7S' _
4' ADDRESS` 3 /l 03 /A'e�1'b'�^"1.�, ZIP?? G Oyes ❑No ❑ Req'd.Type Const. Occupancy Sprinklered
c
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 cliNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. 0 PLMB. l MECH: 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK�
Ci� Jy ` FEES COLLECTED
8. N( ettJ
VALUATION Source
GAS ELECTRIC WATER SEWER
of
9. Utilities 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. Plumbing
� j� rA o , > 2pD
DATE V____ 1 SIGNATURE or '_ .4,... ' . .1.1 Mech. /
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. /^; /��7 �y Plan Check
Env.Health 9 fl )l1 /may/ L ( �
{J (,/ " ` //� SEPA o
Planning — v
LU
a-
Mobile Home rn
Fire Marshall Z
Co. Engineer Other (Specify)
Utilities , G e
TOTAL $ Z --
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist Q --}._, THIS BECOMES A PERMIT.
DATE OFFICIA — -
APPROVED FOR ISSUANCE —