HomeMy WebLinkAbout1979, 11-14 Permit: 79-7794 Gas FurnaceAk
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
x`71 `i E
LOT
BLOCK SUBDIVISION
3.
OWNER
LEGAL DESCRIPTION — SEE ATTACHED
Cul
ADDRESS a
Ji4 0l�a.aZi Co le-1,
o C RACTOR db-w.eyi L01049(1
AD RESig 4 as/ ,
• DESIGNER
PHONE
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PARCEL NUMBER /S
PHONE
ZIP
PHONE
Required Set Backs in Feet
North 'South East (West
Size of Parcel Zone Classification
Type Const.
Valuation
Occupancy
Sprinklered
Eyes ONo ❑ Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area
Garage Area
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑AD N. ''RPL. ❑ MVE.
ECH: ❑ M.H.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Storage
Rancher
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK /
8. (° 3)f q % IL
8.
Source
of
9. Utilities
riTt12
WATER
SEWER
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 o work will be complied with whether specified herein or not. The granting of a permit does not presume
to giv authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.
DATE I </0/1) 10
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
)6" - 1 5
`( -
fLJ/fwd flu
DATE OFFICIAL
FEES COLLECTED
Single $
Building
Plumbing
Mech. 1 (1)
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ !JIL)
PERMIT NUMBER '] -1g
DATE
04* *1200
* 1200
* 12006
B
*000 8
779,32
11 -14 -79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS IBF�C�O 1E�S A 7E,�iMIT.
779,45 *1200
OJ
dH
APPROVED FOR ISSUANCE —
c
L
RECORD OF INSPECTIONS
Final Inspection
DATE REMARKS INSPECTED BY
2
cisCiAO
cry
41500