1980, 10-06 Permit M80B-1468 Furnace, Heat PumpAPPLICATION/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
f shy/
LOT BLOCK
t
SUBDIVISION
OWNER
Lt 4.5,/6)
ADDRESS
3 A G, 5. /ar r,S //e/t)4- efri{
CONTRACTOR ,[ �/ y�
4. A eit Q'k',? I t //iv / r.a. y f�tc %it, ra / f'w-
ADDRESS
F /.& 740 5:ert &.vim tv/2
DESIGNER
5.
PHONE
- Are;
ZIP
;yam ei
PHONE
ZIP
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South
East
(West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation 1 Building Area in Sq. Ft.
ADDRES`;
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Req'd.
Not Req'd.
DESCRIBE WORK
8. e.., , 7 Gz-'6'r /C
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist.
'Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
I hereby certify that 1 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 f0 -- 3 --5-0
SIGNATURE OF APPLICANT . "-
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Dc ct-
/-/•�
Plan Check
SEPA
Mobile Home
Other (Specify)
3:Oo
e/r 00
4i.D60
TOTAL $ /3,UC'
PERMIT NUMBER I
N goL3—f�L-''
04* *13.00
* 1 3.00e 5
* 13.006
A *0,00
1467z
10-06-80
g 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Bui ding Tech icia rr
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
10 i~ 0 6114 8101
DATE ISSUED
1'4 6. 85
*13,002
PERMIT NO. TOTAL