1980, 02-21 Permit M80-1426 Furnace'PLAN 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
/ ,50 3 /17/�?s/.."i/
LOT BLOCK
SUBDIVISION
OWNER J�
ADDRESS
/9A7
)NTRACTOR
ONE .
fa
ZIP
PHONE /
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North
Size of Parcel
South
East
West
Zone Classification
A RESS
)/ Z- .
DESIGNER
5. ADDRESS
PHONE
Type Const.
Valuation
Occupancy
Sprinklered
❑Yes ❑No D Req'd.
Building
Area in
ZIP
DWL Area I Basement Area Garage Area
CHANGE OF USE FROM
6.
TO
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
O PLMB.
❑ AD'N. .L`F RPL. ❑ MVE.
XMECH: 0 M.H. 0 POOL
0 OTHER
Split Entry
No. Baths
Sq. Ft.
Storage
Split Level Rancher
No. Floors
No. Rooms
CERTIFICATE
of EXEMPTION
Rec. Room
Req'd. Rec'd.
Not Req'd.
VALUATION
9.
SCRIBE WORK
5 c i Qi` ,r244, ✓qea/ .Cxis/r�/dx .0/ /,)3
Source, GAS
of
Utilities
ELECTRIC
//) S'0o0 ix,T
WATER SEWER
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 8r SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
MOME OWNER'S WARRANTY
YES Li
NO —I
SPECIAL CONDITIONS:
DATE _______-IDOFFICIAL4) a
APPROVED FOR ISSUANCE _
FEES COLLECTED
Single $
Building
Plumbing
Mech,
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ I/ DL?
PERMIT NUMBER
�- (A42.110
DATE
04 * * 1 1.00
* 11.00
* 11.006
E *0,00
1 42.5B
02-21-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
02.f21'-)30 142,65 *11.00.°�