1980, 12-22 Permit: 80B-5142 FurnacePLAN NUMBER -� APPLICATION/ PERMIT
SPOKANE CUNTY — BUILDING CODES DEPARTMENT
b NORTH 811 JEF ERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SP CES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. 45-. - 2.3 LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCISTJBDIVISION PARCEL NUMBER/S
2.
OWNER PHONE
3. m1wr1A — 1627
ADbReSS ZIP Actual Set Backs in Feet
North South East West
CONTRACTOR
Pht
Size of Parcel
Zone Classification
` T7�$
.._ `to
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
r. 8-7/6— `
of.i
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
I Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
I
TYPE NEW 1-1 ALT. ❑ AD'N. 1:3 RPL. El MVE.
No. Bo.
aths
N Stories I
No. Rooms
No. of Dwelling!
7 El OTHER
�
WORK 1:1 BLD. 1:1PLMB. LYJ MECH. EJM.H. 11 POOL
CERTIFICATE
Req'd. I
Recd.
Not Req'd.
of EXEMPTION
DESCRIBE WORK
Enum. Dist. Location (Area)
�.
8. 1 CC 7-1-01 C f "FLIV 4CC i aU CT _ W O,ti1•\
I
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
-T
USE CODE
9.
OF
UTILITIES
Public El Private ❑
Single $
1 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
Building
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
Plumbing
DATE OF APPLICATION _a �7 a SIGNATURE OF APPLICANT ;51.fdeig
Mech. �
SPECIAL APPROVALS
NAME DATE
nv. Health
anning
ire Marshall
o. Engineer
tilities
ans Examiner
AL CONDITIONS:
cian PERMIT IS NONTRANSFERABLE
F.. ]:��L] PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
fif. ty-v Other (Specify)
TOTAL $ F
P€R'MIT NUMBER
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
• i
51 4 2 21
DATE ISSUED PERMIT NO.
r
*7.00 01
TOTAL