1980, 03-21 Permit: 80-2522 FurnacePLAN NUMBER APPLICAm"ON/PERMIT
PERMIT NUMBER _I
-
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE 7 V
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
4 9.0 0
% C 0 LO
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
�t L, 0 0 c' v
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
I
,= o ; C
- (J' J'-'
OWNER
_...� I�
J �' tc�
PHONE
�),� c-7 � 1�
3.
2521
ADDRESS
ZIP
Required Set Backs in Feet
1 L .k � ��
North South East West
_ 2 1 — 8 0
03
7 9
CONTRACTOR
PHONE
Size of Parcel
Zone Classification64
4'
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
I
Dyes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE E]NEVf ❑ ALT. � AWN.ElRPL. ElMVE,
No. Baths
No. Floors
No. Rooms
Rec. Room
%, OF OTHER
CERTIFICATE
Req'd.
I Rec'd.
Not Req'd.
WORK ❑ BLD. ❑ PLMB. �MECH: ❑ M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK,`
a�^
FEES COLLECTED
8� f�\�1
VALUAT
Source
GASLECTRIC
WATER
SEWER
9.
Utilities
li
'
\ x
I
I
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
r
_ 10
DATE �` < %' SIGNATURES' �-x s I
Mech. • ' �,
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
z
SEPA
c,
Planning
n_
Fire Marshall Mobile Home
-
Co. Engineer Other (Specify)
Utilities �� 6
TOTAL $ ttt
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist n i THIS BECOMES A PERMIT.
_
may^ ,�Z'J]7,�r." IhV1 6 %,i—
DATE•y�' i OFFICIAL CLY�=f_ i
--
APPROVED FOR ISSUANCE
—