1979, 12-13 Permit: 79-9062 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
JOB ADDRESS
1 LO BLO SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
2.
OWNER
—,
3 r• .�� �.
ADDR'�
71-C—F7 /l
PHONE
-%-33 4
ZIP
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
East 'West
CONT TOR
Lam+�
4' ADD ES
5.
_5'76
DESIGNER 'J
ADDRESS
PH O
-7 y
PHONE
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
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
7.
TYPE
OF
WORK
❑ NEW
O BLD.
O ALT. ❑ AD'N. ❑ RPL. 0 MVE.
O PLMB. MECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
9.
DSC R I BEWORK
/1114-0i TIO04
LUATION
Source
of
Utilities
GAS
C? /W\
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 grantin: of a permit does not presume
to give authority to violate or cancel the provisions of any other stateror local .w reg g construction or the
performance of cory4tructyon.
DATE
DEPT.
,J SPECIAL APPROVALS
REQ'D. REC'D.
SIG Thi
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SPECIAL ONDITIONS:
/5 /
//
SEPA Checklist /.z_ALS—
OFFICIA
APPROVED FOR ISSUANCE
. 4,a_/ 7z A10.4- _II471-7 DATE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
j
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ / 41U
G
PERMIT NUMBER
DATE / 7‘i
04*
* 1200
* 1200 n
90612
12-13-79
6,479.
— L
c
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12' -Il 3s=7�9'
906.20 *1.200;20