1979, 11-01 Permit: 79-7131 FurnacePLAN 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
�Q/(o LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK ISUBDIVISION PARCEL NUMBER/S
Required Set Backs in Feet
OWNER
North South
East West
PHONE
Zone Classification
Type Const.
Occupancy
3.
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
ADDRESS
.
DWL Area
ZIP
Garage Area
Storage
�.;2a
Split Entry
CO T ACTOR
Rancher
PHONE
No. Baths
No. Floors
4.
ADDRESS
ZIP
CERTIFICATE
Req'd.
Recd.
Not Rei
of EXEMPTION
DESIG ER
PHONE
5.
ADDRESS
ZIP
CHANGE OF USE FROM
TO
6.
TYPE ❑ NEW 1-1 ALT.
ElAD'N. ❑ RPL.
E3 MVE.
7
OF
❑ OTHER
WORK ElBLD. ❑ PLMB.
MECH: ❑ M.H.
11POOL
Required Set Backs in Feet
North South
East West
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
DWL Area
Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
Req'd.
Recd.
Not Rei
of EXEMPTION
8 r ( t&FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities � X Single $
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 Building
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
Plumbing
performance of construction.
DATE SIGNATURE— Mech.�
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
hecklist
PERM MBER
DATE
04* *7.00
*7,00
*7=0061
r L
E *COQ, �>
71 3.09
1 1 -01 -79
R 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
< � ` THIS-BF�COMES A PE�MIT.
DATE OFFIC-
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