1979, 11-21 Permit: 79-8196 Space HeaterPLAN NUMBER
APPLICATION/ PERMIT
PERMIT NUMBER
SPOKANE COWNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE
J < ""� ;f o r�
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
T
* * `'"0
JOB ADDRESS
�" " f
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BL K
PARCEL NUMBER/S
2.
ISUBDIVISION
* 1 200 _.
OWNER 1
�c
PI QNE�
3.
810 5
ADDR
ZIP
Required Set Backs in Feet
North South East West
11 _,21-79
(j 7 C'
CO TRACT
1 -
'�
PHONE
/
'ze of Parcel
Zone Classification
4. ADD SS
(�
ZIP
Type Const.
Occupancy
Sprinklered
6
F Q
❑Yes ❑No ❑ Req'd.
DESIGNE
PH NE
Valuation
Building Area in Sq. Ft.
5.
_
ADDRESS
ZIP
DWL Area
I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE El NEW 11 ALT. ElAD'N. 1:1 RPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF
❑ BLD. ❑ PLMB. �rwECH: ❑ M.H.
❑ OTHER
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRI E O
-� -7°AXJFEES COLLECTED
VALUATION Source : AS
ELECTR ATER SEWER
9. Utilioifties L
Single $
I hereby certify that 1 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.
-1 Plumbing
DATE if .� �:' r;l'
SIGNATURE_�,� r'
Mech.
SPECIAL APPROVALS
SPECIAL NDITIONS:
DEPT. REQ'D. REC'D.
^ Plan Check
�J
Env. Health
SEPA
Planning
/
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Utilities
;/
TOTAL
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist
/ _ •�vTHIS BECOMESA PERMIT.
90
it r
J-
DATE OFFICIAL / �/i �i..V�