1980, 12-05 Permit G80B-4500 Furnace(PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
PERMIT NUMBER
hot— 4_400
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
B OCK
LOT
OWNER
3.
ADDRESS
DESIGNER
ADDRESS
6.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JUtSUIVISIUN
/ 1 7 L i= ✓UT
CHANGE OF USE FROM
TYPE
7. OF
WORK
9.
PHONE
PHONE C/
1 /�/ Y%<�
ZIP
7%
PHONE
fa NEW ❑ ALT. ❑ AD N. ❑ RPL. 0 MVE.
❑ BLD. ❑ PLMB. L /MECH. ❑ M.H. ❑ POOL
DESCRIBE WORK
VALUATION SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
0 OTHER
l'
SEWER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North South
Size of Parcel
Type Const.
Valuation
Main Floor
Area of Decks
Occupancy
Upper Floors
CERTIFICATE
of EXEMPTION
Ownership
Public 0 Private 0
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Finished Basement Unfln. Basement
USE CODE
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
1TE OF APPLICATION SIGNATURE OF APPLICANT )
No. Rooms INo. of Dwellings
Req'd. Rec d.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. J
Plan Check
SEPA
Mobile Home
Other (Specify)
Cy•
TOTAL $ / 0
0
04*
*9,00
*9.00 i
*9,0(Th
*0,00
4499g
12-05-80
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
I
• k .o a':5 aa,z
DATE ISSUED
PERMIT NO.
St '
* PfUfiOtte .
•TOTAL