HomeMy WebLinkAbout1979, 12-05 Permit: 79-8716 Oil FurnacePLAN 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
1.
2.
JOB AI DRESS
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER /S
OWNER
3. , / (j i c2- /1/ GC r > ! ,f3
ADDRESS / / /4
PHONE '/
TRAC OR
4. c y'y// f c ( (
ADD SS
/ 7 , /G° /' 1} ; Li , 5 , 4 f'1
DESIGNER
5' ADDRESS
Z 1�
C.7)().„20
Required Set Backs in Feet
North 'South 1East 'West
PHONE
/.� /
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation (Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area ( Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
2/NEW ❑ ALT. ,❑ AAp N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. MECH: ❑ M.H. ❑ POOL
❑ OTHER
8.
9.
DESCRIBE WORK
t _ / t
VALUATION
/r:,;
Source
of
Utilities
GAS
1/' 6,5/ <, / /
ELECTRIC
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
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 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 / / -:. C�_ 7(2 SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITION
DATE/a-71) ?OFFICIAL_/ w�
APPROVED FOR ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
4
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBE�
1 —% 6
DATE /// 9- / %.
04* *11,00
* 1 1,00
* 1 1,006
E *000
871.52
12 -05 -79
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BEq0MES A PE,RMIT. O
1 —0 '77, 871,,6o 3 *11.00 P
RECORD OF INSPECTIONS
DATE REMARKS
0
Final Inspection
INSPECTED BY
Y O ;}
¢ �iCO..
rya
* j .a
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