1979, 08-16 Permit: 79-2347 Ductwork1 PLAN NUMBER
i
APPLI j.rION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
14).0 .D. _+1
LOT
BL
3.
OWNER
ADDRESS
SUBDIVISION
P. d a- OA
4' ADDRESS
CONTRACTOR
76+ld-e v,dorCncc,c�
PHONE
ZIP
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North !South East (West
Size of Parcet
Zone Classification
'309
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
Valuation
Building Area in Sq. Ft.
DWL Area I Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
®, NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
• MECH:
❑ RPL.
O M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd. Recd
DESCRIBE WORK
8. 1t.) K.UJ Or
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
X
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 SIGNATURE L!YIXI""" C� Q}n -X.J3
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE C>
5
OFFICI
APPROR ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
I Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
c: C
TOTAL $ l• c> c)
PERMIT NUMBER
04* *7.00
*7.00 N
*7.006
A *000 0
23&6R
08-16-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08-16-79
23472 *7,00
O
a H