1980, 08-13 Permit: 80-8467 FurnacePLAN, NUMBEt(
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
3.
JOB ADDRESS 37'774
E. B -
LOT BLOC
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
OWNER
ROTH C-(11-.
ADDRESS
r= . i010 FERRE—r.D. ,
CONTRACTOR
4. AR -I HEATI1l>e/CbtJp, IV -
ADDRESS
-. X614 c jE
L
DES! NER
5' ADDRESS
PHONE
/745-6--cloo
ZIP
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South
East
'West
PHONE
- C SI
Size of Parcel
Zone Classification
PHONE
Type Const.
Valuation
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
NEW
0 BLD.
O ALT.
❑ PLMB.
❑ AD N.
X] MECH.
❑ RPL.
O M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8' II*) NLL F tr2 JI CE
VALUATION
9.
SOURCE GAS
OF
UTILITIES
Enum. Dist.
`7kACTwc k
ILocation (Area)
ELECTRIC
WATE R
SEWER
Ownership
Public 0 Private 0
USE CODE
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
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
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL ?PPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
T>chnician
•
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /r60
- PERM-1141UMBER
04* *7.00
*7.00
*7.006
E *0,00
84662
08-13-80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08-1)-8'0
DATE ISSUED
846,75
PERMIT NO.
*7.00°
TOTAL