1979, 10-17 Permit: 79-6177 Furnace1
PLAN 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
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
ESS
4.
0
CO TR Aj' R
A DRESS
?f34"/
DESIGNER
PHONE
ZIP
ZIP •
5' ADDRESS
CHANGE
6.
TYPE
7. OF
WORK
r USE FROM
❑ NEW
D BLD.
O ALT.
❑ PLMB.
TO
❑ AD'N.
CIVIECH:
PHONE
ZIP
❑ ❑MVE.
❑ M.H. 0 POOL
0 OTHER
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
East
Size of Parcel
West
Zone Classification
Type Cons
Occupancy
Valuation
DWL Area I Basement Area
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Split Entry
No. Baths
Split Level
No. Floors
Storage
Rancher
No. Rooms Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
9.
DESCRIBE WOI
UATION
Source
of
Utilities
G
ELECTRIC
�I00)00D 4 SET )
WAT R
A
I hereby certify that Ihave read and
on reverse side, and know the same
type of work will ticomplied with
to give authority ttriblate or cancel
performance of construction.
DATE / /7— 7 q
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 o .er state or local law regul.ing construction or the
SIGNAT
SPECIAL APPROVALS
DEPT. REQ'D.
REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SP L CONDITIONS:
DATE
cr
7 , OFFIC
I1
APP' :"` FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
sif
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
DATE
PERMIT NUMBER
04* *1200
* 12.00 N
* 12006
E *Q00
617.6
10-17-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-17-79 617.7 z
*1 2 0; 0 r2
DATE
RECORD OF INSPECTIONS
T f;
Final Inspection
REMARKS INSPECTED BY
V1.16
10 -1A -Ad
.1FI
*fjjw_
•150OR
4
4.1500 g2
*JSCO