1979, 07-31 Permit: 79-1276 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
PERMIT NUMBER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
N tntc
LOT BLOCK SUBDIVISION�''�i"
2.
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/5
O N R
3.
ADDRESS
f21/44(a
CONTRACTOR
4'
ADDRES
S
5' ADDRESS
DESI�W4R
PHONE
P G�
Z�1 i_•< Y'2 o)
Required Set Backs in Feet
North 'South East 'West
PHONE_ ..
TLC -Sp o
ZI P
PHONE
Size of Parcel Zone Classification
Type Const.
Occupancy
Sprinklered
Dyes ONo D Req'd.
Valuation 'Building Area in Sq. Ft.
ZIP
DWL Area
Basement Area I Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK D BLD.
DESCRIBE WORK
8. -� �
a -J -
VALUAT`ION
9.
TO
Split Entry
Split Level
Rancher
O ALT. ❑ AD N. 0 RPL. D MVE.
O PLMB. `Lf MECH: ❑ M.H. D POOL
Source
of
Utilities
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Pao -k Orr
GAS ELECTRIC WATER SEWER
Req'd.
Recd.
Not Req'd.
I hereby certify that.( 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.
tt,'
DATE Z -7 - SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
' SEPA Checklist
SPECIAL CONDITIONS:
DATE/° � OF
APP
IC
V
FOR ISSUANCE
FEES COLLECTED'
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ \'5t.
04* *1500
* 1500
* 15006
E *Q00 S
127.52
07=31-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07-3L-79
127,65 *15.00°,
C
0
U
w
Cl..
DATE
4
RECORD OF INSPECTIONS
Final inspection
REMARKS INSPECTED BY
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F AO GC, 8
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+�120C