1979, 08-15 Permit: 79-2264 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
LEGAL DESCRIPTION — SEE ATTACHED
DATE
PERMIT NUMBER
04* *9,00
*9,00 ui
*9.00
A *0.00
226.3
08-15-79
2 6.479,
8.5 '/!W %,- O N0 ' !
VALUATION Source GAS ELEC RIC WATER SEWER
of
9. Utilities Single $
OWNERl
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
P ONE
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
3.
Plumbing
performance of construction,
V
DATE /�/ S I G N A T U R
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
ADDRESS
Env. Health /
ZIP
Required Set Backs in Feet
Planning
4/L -7i %
J / �
Co. Engineer Other (Specify)
Utilities
North South
East West
CONTR CTOR
PHONrE
Size of Parcel
Zone Classification
l*
4.
ADDELES7
ZI
���%
Type Const.
Occupancy
Sprinklered
C/H12 �_
❑Yes ❑No El Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF U E FROM
TO
Split Entry
Split Level
Rancher
6.
(
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE 1-1NEW E) ALT.
1:1AD'N.
El RPL.
ElMVE.
7,
OF
❑ BLD. ❑ PLMB.
)KMECH:
❑ M. H.
❑ OTHER
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
CRIBE WORK
FEES COLLECTED
DATE
PERMIT NUMBER
04* *9,00
*9,00 ui
*9.00
A *0.00
226.3
08-15-79
2 6.479,
8.5 '/!W %,- O N0 ' !
VALUATION Source GAS ELEC RIC WATER SEWER
of
9. Utilities 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 /�/ S I G N A T U R
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
i
Env. Health /
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
SEPA Checklist
DATE 0 J 7 �OFFI
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS,T5,COYErS A PE�MIT.
1. 0 — 1 7 J, _>