1980, 01-29 Permit: 80-666 FurnacePLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
LEGAL DESCRIPTION —SEE ATTACHED
LOT I BLOCK SUBDIVISION PARCEL NUMBER/S
2.
OWNER
PHONE
,
-�- c'�-q7
3.
ADDRESS
`S
ZIP
Required Set Backs in Feet
1,)r`
�)
� - ) I
c, &'
—
�'� �
'�
I
North South
East West
CONTRACTOR
HONE
Size of Parcel
Zone Classification
L
('�s. -
I 2-',,- s Z j�Z_
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
L_ % 3 C-, 11'
G
-) C.) U 6,
I
❑Yes ❑No ❑ Req'd.
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.
TYPE ®' NEW
El ALT.
11AD'N.
1:1 RPL.
ElMVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF
❑ OTHER
CERTIFICATE
Req'tl.
Recd.
Nat Req'd.
1:1BLD. 1:1PLMB. �Rt MECH: ❑ M.H. 1:1POOL
WORK
of EXEMPTION
DESCRIBE WORK
8 I` �� L� t� ` �`�� FEES COLLECTED
VALUATION Fustol-ul",
ce GA ELECTRIC WATER SEWER
�. xQ, ies 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 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
DATE /'- Z,�SSi�, SIGNATURE ��� E—<—�✓` r Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT_ REQ'D. RECD. I Plan Check
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist ryry ��//��
DATE I:&q:71�oFFI CI A,
APPROVED FOR ISSUANCE
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBEk
DATE _ 2--
7
TOTA L $ (,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
y.-
�7