1979, 10-19 Permit: 79-6381 FurnacePLAN NUMBER APPLICAtION/PERMIT
PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
► NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
0 4 * *7-00
* 7.0 0 U
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
1.
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
I
E *0.00 00
OWNER
PHONE
vG,sc_,C3
63a0.?
3.
10-19-79
ADDRESS ff
ZIP
Required Set Backs in Feet
`A% ( j c C.�' o LVA L
North South East West
2 6479,
CONTRACTOR
ONE
Size of Parcel
Zone Classification
4. ADDRESS
Z
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7B�7
No. Floors
No. Rooms
Rec. Roam
7, OF ❑ OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
❑ BLD. ❑ PLMB. �iklMECH: ❑ M.H. ❑ POOL
WORK
of EXEMPTION
I
DESCRIBE WORK
FEES COLLECTED
1 O
8 `�
-C�GA-S
VALUATION
Source
EL TRIC
WATER
SEWER
9,
of
utilities
x x k
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
performance of construction. Plumbing
DATE SIGNATURE—Mech. U P�
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT., REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Z
Co. Engineer Other (Specify)
Utilities
TOTAL $�'
Zone Clearance
IN THIS SPACE,
WHEN MACHINE VALIDATED
SEPA Checklist THIS BECOMES A PERMIT.
1 L.._ Z 9'-?
.
3. 1I-
DATED
�
-FFICI
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