1980, 03-11 Permit G-80-2046 FurnacePI AN NUMBER
L
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
LOT
2.
SUBDIVISION
OWNER
3. HONST )
ADDRESS
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
East
West
CONTRACTOR
A- 1 HEAT-IA/41 q A)d?,kOnJ7
4- ADDRESS
E. WE/LE
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
44fs9- 95 1
ZIP
PHONE
ZIP
Size of Parcel
Type Const.
Occupancy
Valuation
DWL Area I Basement Area
Split Entry
Zone Classification
Sprinklered
DYes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Split Level
TYPE
7. OF
WORK
ANEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
DESCRIBE WORK
No. Baths
No. Floors
CERTI FICATE
of EXEMPTION
8. j/JS'AT ON 10g XO 61 /.4 urce cRJ FuR/V ACE GASEL'EC�Lflsl wDRIC
VALUA
of
9. Utilities
XX
WATER
SEWER
No. Rooms
I 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.
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SPECIAL CONDITIONS:
Storage
Rancher
Rec. Room
Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ I/, 00
PERMIT NUMBER
DATE
04.* * 1 7,00
*. 17,00
* 1 7,008
E *0.00 8
204,52
03-11=80
2 6479,
SEPA Checklist
DATE. 1I_
OFFICIAL
193..tc-A1CAAA/v%-cw\
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
zo1.6a
*17,O.OaI-
RULES:
(1) Building must be 5' from property line
(2) Building must be 10' from drain field
(3) Building must be 25' from property line
if property line is next to a street
(4) Building must be 10' from all existing bldgs.
HOMEOWNER: -
ADDRESS: Ei kcw J
(A- ,.: < .
PARCEL No.
LEGAL:.:....
1. Draw in all existing buildings.
2. Draw in new building & how many feet it is from existing buildings and property lines.
3. Name all roads next to property.
4. Draw in drain field and whether you are on a septic tank or sewage system.