1979, 08-16 Permit: 79-2349 FurnacePLAN NUMBER
APPLIL ..:ON/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
Isn 40
LOT
BLOCK
SUBDIVISION
cs,r,11
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
-c
ADDRESS
• o -a9-K,
CONTRACTOR
4 fl�erdo� Cur'hac.Q
' ADDRESS
PHONE
ZIP
PHONE
..).–CtZs 2—
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East
West
93z:9 '16'e-vr
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
!ANEW
❑ BLD.
O ALT.
O PLMB.
PHONE
ZIP
TO
❑ AD'N.
• MECH:
❑ RPL.
O M.H.
❑ MVE.
O POOL
0 OTHER
Size of Parcel
Type Const.
Valuation
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
DWL Area I Basement Area Garage Area
Split Entry
Split Level
No. Baths
No. Floors
No. Rooms
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIBE WORK
8. -k-i r[ S c. D \ UJ
U
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
xx
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. \i 1
DATE SIGNATURE J
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
Storage
Rancher
Rec. Room
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. ' D C,r
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ' 0 4/
PERMIT NUMBER
DATE
04*
A
234,82
08-16-79
2 6479.
*7.00
*700 5
*7008
*Q00 8
WHEN MACHINE VALIDATED IN THIS SPACE,
7HISu-8COMESA-9-PERMIT.
23492
*7.00°H.
c
L
DATE
RECORD OF INSPECTIONS
Final Inspection
REMARKS INSPECTED BY
2-‘1.10
oii-JF-AO
4_.00