1980, 10-15 Permit M80B-2016 Furnace, Ht PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
PERMIT NUMBER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT
2
B OCK
'JVCUI V1 ICJ IN
OWNER
3.
ADD ESS
/7 7
FJ. ADDRESS
CONTRACTOR
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ADDR /lrZ4/ /1 ,1 ���
DESIGNER
CHANGE OF USE FROM
6.
TO
PHONE
3:..,S':;" J71`/
ZIP
PHONE
ZIP
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South
East
(West
Size of Parcel Zone Classification
Type Const.
Occupancy Sprinklered
DYes DNo ❑ Req'd.
Valuation Building Area In Sq. Ft.
Main Floor
Upper Floors
Garage Area
Storage
Area of Decks
Finished Basement Unfin. Basement
TYPE
7. OF
WORK
Ira.NEW ❑ ALT. ❑ AD N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. 41'MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd. Rec'd.
DESCRIBE WOR{S. �// ��
8. �, �_ e,-a7 7`'-///4a.c- z?' /f/.t%( d!/!%
VALUATION SOURCE —GAS ELECTRIC WATER SEWER
OF
9. UTILITIES (J
Enum. DIst.
Location (Area)
Ownership
Public 0 Private 0
USE CODE
1 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
DATE OF APPLICATION ZO-.77-r".. d D
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SIGNATURE OF APPLICANT.
SPECIAL CONDITIONS:
r
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
9 rs ci
Mech. / ^�
Plan Check
SEPA
Mobile Home
Other (Specify)
►-OC/
TOTAL $ / S
04* *15.00
•*15,00 L
'*1 5,006
A *0.00
201.5g
10+15-80
2 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
ng Techni Ian
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
tl 0 r l -84,0'
DATE ISSUED
•
2'0165 *11:5.00a�-
PERMIT NO. ' TOTAL