1980, 02-25 Permit: 80-1466 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 t I-,
1. � I I � 1' 0 LEGAL DESCRIPTION - SEE ATTACHED
2. LOT I BLOCK IS DI ISION
PARCEL NUMBER/S
OWNER 1 PHONE
3.
ADDRESS _ /`'� ZIP Required Set Backs in Feet
I ( ) �' North South East West
CONTRACTOR PHONE Size of Parcel
Zone Classification
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ElReq'd.
DESIGNER
5. PHONE Valuation
Building Area in Sq. Ft.
ADDRESS ZIP DWL Area Basement Area Garage Area Storage
6. CHANGE OF USE FROM TO Split Entry Split Level
Rancher
TYPE `9I NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. No. Baths No. Floors No. Rooms Rec. Room
7. OF "'� ❑ OTHER
WORK ❑BLD. ❑ PLMB. �MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
DESCRIBE WORK
of EXEMPTION
8. E � i< k.v . (�J � 2_�G FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of X
9• utilities
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. -�9 Plumbing
Ci DATE - ( l — SIGNATURE 2a�- � =ZJ (/
Mech. • c'
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ -D. RECD. Plan Check
Env. Health
Planning SEPA
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
Utilities
Zone Clearance
+ TOTAL
$� J
SEPA Checklist
DATE '&M!6'--50IFFlC IAL
APPROVED FOR ISSUANCE
PERMIT NUM 1�4
DATE 2-
04* *7.00
*7.00 U
*7.0061
E *000 Cc
1465-4
02-25-80
;R 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS.B,COI)(I A,�ERMIT. , 66
I-