1979, 08-08 Permit: 79-1792 Furnacec
PLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDiNG CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
/LjI�SCRIBE WORK.
8. /(% �% 'G / i
VALUATION Source CAASELECTRIC W ER SEWER
.. .of -
Q, Utilities
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 ocal law regulating constru io or the
perform?e ofc nstruc%tioonnn.. n
DATE ` / / SIGNATURE
SPECIAL APPROVALS SPECIAL CONDITION :
DEPT. REQ'D. REC'D. / la Seo
Env. Health / Ila
26 �.
Planning
Fire Marshall '
Co. Engineer
Utilities.
Zone Clearance
SEPA Checklist t
DATE OFAL
TSA RO FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) -
0 4
Specify)
DATE
PERMIT NUMBER
G -7� - 179
04 * *1 200
*-1200 N
*12006
A *a00
1 7 9. 1 2
08-08,=79
;2 61479.
TOTAL $ L_
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 8:.110.8.;; 7.9 17 9.2 z
*1.200a�_ _
.,
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
Jo�,�-, �- „
LEGAL DESCRIPTION — SEE ATTACHED
LOT--tlLOCKjSUBUIVISIUN"-
-��"'---'---�
PARCEL NUMBER/S
2.
]::2
/✓aid , .
::
s.�
,6
A9D�'.���''—� `1'
Required Set Backs in Feet '
South East West
ICON-
_North
1
AC'TOR_ '
���
Size of Parcel
Zone Classification
>`-�•
4.�AYESS
Type Const.
Occupancy
Sprinklered
IP
❑Yes❑No ❑ Req'd.
DESIGNER
Valuation
Building Area in Sq. Ft.
5ADDRESS
OWL Area
Basement Area
Garage Area
Storage
CH QF U E FROM
TO (
Split Entry
Split Level
Rancher
6.
I
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE ❑ NEW 1-1 ALT. � 1:1AD'N. ElRPL.
❑ MVE.
7,
OF
❑ OTHER
❑ BLD. ❑ PLMB. H: [IM.H.
El
"CERTIFICATE"
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION .
/LjI�SCRIBE WORK.
8. /(% �% 'G / i
VALUATION Source CAASELECTRIC W ER SEWER
.. .of -
Q, Utilities
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 ocal law regulating constru io or the
perform?e ofc nstruc%tioonnn.. n
DATE ` / / SIGNATURE
SPECIAL APPROVALS SPECIAL CONDITION :
DEPT. REQ'D. REC'D. / la Seo
Env. Health / Ila
26 �.
Planning
Fire Marshall '
Co. Engineer
Utilities.
Zone Clearance
SEPA Checklist t
DATE OFAL
TSA RO FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) -
0 4
Specify)
DATE
PERMIT NUMBER
G -7� - 179
04 * *1 200
*-1200 N
*12006
A *a00
1 7 9. 1 2
08-08,=79
;2 61479.
TOTAL $ L_
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 8:.110.8.;; 7.9 17 9.2 z
*1.200a�_ _
.,