1979, 09-20 Permit: G79-4387 FurnaceBuilding Area in Sq. Ft.
(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
>) //a— d
LOT BLOCK SUBDIVISION
2.
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
OWNER
3 Ai — ' w f t�� -» L 7tt -7-rk ►. S !Z
ADDRESS
5Q --tt
CONTRACTOR
4. /*7 >r E 0 � u I �1 �d
DDRESS
DESIGNER
5.
ADDRESS
PHONE
ez
4''ge, 6
CHANGE OF USE FROM
6. /
TO 6. C
PHONE
c3y-`f 975
Pz(2,6
PHONE
ZIP
Required Set Backs in Feet
North (South {East (West
Size of Parcel
Zone Classification
Type Const.
Occupancy
Valuation
DWL Area
Split Entry
Basement Area
Sprinklered
❑Yes ❑No ❑ Req'd.
Garage Area
Storage
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
MECH:
❑ RPL. 0 MVE.
❑ M.H. 0 POOL
D SCRIB
8.rl�!' .•�G3-2
VALUATION
Source
of
Utilities
GAS
li'eomo ATL
9.
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
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 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
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
J
DATE O OFFIC
APPRO~ i FOR ISSUANCE
et
FEES COLLECTED
Single $
Building
Plumbing
o
Mech. ✓/GJay,,-4)2' _—
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$/ate°
DATE
PERMIT NUMBER
9 3B 1
04* *1200
* 1200 tz
* 1200,5
E *0.00
43878
09-20-79
B 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THISOBECOMEES A PERMIT.
LZ 7 4'3 8.8 z
*12002F