1980, 10-23 Permit G80B-1008 FurnacePLAN 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
1.
JOB ADDRESS
l//Z ' //4// l% le5/1
LOT
2.
B OCK
3.
JUuUI V ISIUIN
OWNER /
Th A/✓ L , Lae-4-il✓
ADDRESS
/2 7<< 7, /`l.9✓.,
CONTRACTOR
4. 734/1/A✓AK_ rL//e ✓AG �"U � Z /L
ADDRESS
PHONE
%1Jo" Kb /
ZIP
PHONE
Zip
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South
Size of Parcel
Type Const.
Occupancy
East
(West
Zone Classification
Sprinklered
DYes DNo ❑ Req'd.
5' ADDRESS
DESIGNER
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
Valuation
Building Area In Sq. Ft.
Main Floor
Upper Floors
Garage Area
Storage
TYPE
7. OF
WORK
❑ NEW ,MALT. ❑ AD'N. 'RPL.
❑ BLD. ❑ PLMB. rMECH. ❑ M.H.
❑ MVE.
0 POOL
❑ OTHER
Area of Decks
No. Baths
Finished Basement
Unfin. Basement
No. Stories
No. Rooms INo. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd. Rec'd.
Not Req'd.
9 SCRIBE WORK
8., ,�P/Ade o/L
VALUATI. N
9.
SOURCE
OF
UTILITIES
GAS
1 /i/G /2 (& 3-05"
ELECT R I C
WATER
SEWER
Enum, Dist.
Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
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
SIGNATURE OF APPLICANT
lr 11:
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
FEES COLLECTED
Single $
Building
Plumbing /
Mech. //' e
Plan Check --
SEPA
Mobile Home
Other (Specify)
TOTAL
$ //do
* 1 1,00
* 1 1.00
* 1 1.01;Th
A *000 8
10072
0'9-26--80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
B ding Tech
A1 'i c /24 /k1.141
cia
n
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
b;,9.^ IO`
DATE ISSUED
100,8z
PERMIT NO.
*11,OOa1-2-
TOTAL