1979, 10-17 Permit: 79-6226 Furnace, Heat PumpPLAN 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
- / G' 50
LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION
OWNE�j
3. /
ADDRESS
PHONE
ZIP
4.
CONTRACTOR
ADDRESS
'/i
rY
DES(
2. lV // 7y
NER
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
PHONE
%IV 713
ZIP
PARCEL NUMBER/S
Required Set Backs in Feet
North (South
East
West
Size of Parcel
Zone Classification
PHONE
ZIP
TO
XNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. MECH: ❑ M.H. ❑ POOL
❑ OTHER
Type Const.
Occupancy Sprinklered
❑Yes ❑No D Req'd.
Valuation
DWL Area
Building Area in Sq. Ft.
Basement Area Garage Area
Split Entry
No. Baths
Split Level
Storage
Ranche
No. Floors No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
9.
DESCRIBE WORK
fd ' �l,L r��AC c -
VALUATION f f Source GAS
of
Utilities
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 /0L6 � SIGNATURE
DEPT.
Env. Health
Plannin
SPECIAL APPROVALS
REQ'D. REC'D.
9
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
.77OFFICI
APPRO
FOR ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
4p/
Other (Specify)
TOTAL $
PERMIT NUMBER
DATE /BA/74/
/7
*13.00
*13,00
*13.006
E *0.00
62252
10-17-79
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B COM APE MIT.
1b -i7-79 61.2.2,(62 *13.0 0 °