1979, 09-06 Permit: 79-3475 Furnace, DuctworkPLAN NL M�ER
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
LOT / / 4
BLOCK SUl 7c(..
LEGAL DESCRIPTION - SEE ATTACHED
OWN't
3. C C �i rrAl_t; lf 4'� f o.✓
ADDRESS
A i; / box /6 i t. de
COON1 RACTOR
/
4. ' + 1Af Lt4-/ // //A ,/ /4,C
ADDRESS
/ A 2 /d Le' ,e a 5, o e G ✓a
DESIGNER /
PHONE
5' ADDRESS
ZIP
PHONE
9•2-F -33/ o
PARCEL NUMBER /S
Required Set Backs in Feet
North 'South
Size of Parcel
ZIP
99'i /G
PHONE
Type Const.
Occupancy
Valuation
East (West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
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
XNEW ❑ ALT. ❑ AD N. ❑ RPL.
❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTI FICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. //v-5 / / Gas Foolec ., sY < P tf pace
VALUATION Source GAS
of
9. Utilities
ELECTRIC
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 / 7 / SIGNATURE
DEPT.
SPECIAL APPROVALS
RECD. REC'D.
Env. Health .
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
h' c %, e /r /Oc ci c' 4 rec. 65
Fteirc
C
i i
DATE 9OFFICI
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
/ 4 6 -f'
SEPA
Mobile Home
Other (Specify)
3,'°�y
3•C'C)
TOTAL $ /r;7. C' a
0
4
PERMIT NUMBER
-
DATE ` — 7
04* *12.00
*12,00
*12.006
A *0,00
347.4
09 -06 -79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THISACOI E6S A NRMIT.
3475° *12.00
O J
RECORD OF INSPECTIONS
Final Inspection
DATE REMARKS INSPECTED BY
as -C9- .1a
*aoc o
* 1500x
+� 1 so0 IS