1979, 09-27 Permit: G79-4866 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
1.
2.
3
JOB ADD S(24 IJN
�c�C-
BLOCK SUBDIVISION
LOT
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
ADDRESS
n L00,0
5cvoivz
CONTRA ToR
4.
ADDRESS C--S1-(_i
2a00 ` f QST i9�
DESIGNER
PHONE
(lac - -34)
IP
PARCEL NUMBER/S
Required Set Backs in Feet
North !South
PHONE
494-13
ZIP
East (West
Size of Parcel I Zone Classification
Type Const.
Occupancy
PHONE
Valuation
5' ADDRESS
ZI P
DWL Area I Basement Area
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area I
CHANGE OF LJSE FROM
6. 1k.
TYPE
7. OF
WORK
TO
❑ NEW I„E'ALT.
❑ BLD.
❑ PLMB.
ves l
Split Entry
Split Level
Storage
Rancher
❑__,, AAO'N. CIRPL. ❑ MVE.
LYMECH: ❑ M.H. CIPOOL
❑ OTHER
No. Baths
CERTIFICA
of EXEMPTION
No. Floors No. Rooms
TE
Req'd.
Rec. Room
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
9.
VALUATION
Source
of
Utilities
ieW ( .C4 ACL.0
ELECTRIC
GAS
ATER0o e r/J
SEWER
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
performance of construction.
DATE •3v ---N
examined this application and have read the "NOTICE" provisions included
to be true and correct. All provisions of laws and ordinances governing this
whether specified herein or not. The granting of a permit does not presume
the provisions of any other state or loc- law regulating construc ion or the
SPECIAL APPROVALS
DEPT. REQ'D.
REC'D.
SIGNATURE
Env. He-Ith
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIO
/-/1
/ ./
O Z
i
i
DATE9.---27-7V OFFICIALICai,
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ `1
PERMIT NUMBER
DATE -1-a3-79
04*
E
48652
09-27-79
2 6,479.
* 1 2.00
* 1200 t5
* 12008
*0.00 S.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09-27-7'9.
486,6 z
*12,0 0
F-
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