1979, 08-29 Permit: 79-3087 FurnacePLAN NUMBER
f
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
2
BLOCK SUBDIVISION/
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER // n
iiS�}�G�i2Qi �Q/�-�2i
ADDRESS O
PHONE
Salo - Z
ZIP
Required Set Backs in Fee
North
South
East IWe
CONTRACTOR
ADE
66S/ \___21:A_
PHONE
CT32/2197S
Size of Parce
Zone Classification
ZIP
Type Cons
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd
DESIGNER
PHONE
Valuation
Building Area in Sq. F
ADDRESS
ZIP
DWL Area
Basement Area
Garage Are
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Ranche
TYPE 0 NEW
7. OF
WORK' 0 BLD.
❑ ALT. 0 AD N.
❑ PLMB. r/Jil'i1ECH
❑ RPL.
❑ M.H.
O MVE.
O POOL
0 OTHER
No. Bath
No. Floor
No. Room
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
p
2aCP��-�wf /00, &JO
VALUATION
9
Source
of
Utilities
GAS
xxx
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 cons`ruction.
DATE SIGNATURE
DEPT
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
/0/
- FEES COLLECTED
Single $
Building
Plumbing
Mech,/a
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $ /a
PERMIT NUMBER
`77 - 30 8 7
DATE
04* *1200
* 1200
* 12008
A *Q00
3086f
08-29-79
& 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0
8..4.'2,9,i7.9 7.9 3'0 8,-7 2
*1200
CC
O
1—
W
d
0,