1979, 10-02 Permit: 79-5140 FurnaceLw
PLAN NUMBER
1
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
J
f't I (2. -VI Ec.e O P -A N t
BDIVI ION
LEGAL DESCRIPTION - SEE ATTACHED
3.
4. ADDRESS
X'")16 -
DESIGNER
OE; e f_ ASS
ADDRESS
t
2--2- ev_i_e±Lq
CONT 1CTO 1 f_
A �� .UALiT`/ C;.
5' ADDRESS
P E
ON94J97e
HONE
ZIP
q9C9,i,
PHONE
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
Size of Parcel
Type Const.
Valuation
Occupancy
East
'West
Zone Classification
Sprink1ered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7, OF
WORK
❑ NEW
O BLD.
O ALT.
O PLMB.
❑ AD'N.
X MECH:
/3`
RPL.
0 M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
SCRIBE WORK
9.
E ?u4 OIC -
VALUATION
,F10E LOI77-i ctc7I',C .
Source
of
Utilities
GAS
�� � WATER
SEWER
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
performance of construction.
DATE lie `f2/M7 7
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 other state or Deal law regulating construction or the
SIGNATURE
DEPT.
- SPECIAL APPROVALS
REQ'D.
REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE IO 2 OFFICI
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Ick
$`,•
-
L. —
Other (Specify)
4-71
TOTAL $ '
DATE
PERMIT NUMBER
04*
E
513.9.2
10-02-79
2 6479,
* 9.00
* 9.00
* 9.006
* 0,00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS,BECO .A PERMIT.
v
_7' 4.0
*9.00a1=1