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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.°�