1979, 08-17 Permit: 79-2376 Gas HookupPLAN 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 db
G LEGAL DESCRIPTION — SEE ATTACHED
Ly l BL CK SU 41VIS10 j , I PARCEL NUMBER/S
OWER
3 il 6,7
ADD E
CONTRACT
4. ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
PHONE
ZIP
RE
ZIP
PHONE
ZIP
I vrt L] NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
% OF 11 OTHER
WORK 1:1BLD. ❑ PLMB. F-1MECH: LlM.H. ❑ POOL
n FGr RIRF vinoic
Required Set Backs in Feet
North South
East West
Size of Parcel
Zone Classification
ELECTRIC
WATER
Type Const.
Occupancy
Sprinklered
T
Dyes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
utilities
DWL Area
Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
I Rec. Room
CERTIFICATE
Req'd.
Recd.
Not Re,
of EXEMPTION
FEES COLLECTED
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
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.
DATE / d �� SIGNATURE
/SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAyL�C,ONDITION%
DAT AqLP4��
OFFI Al-
Required
L
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
-
PERMIT NUMBER
cg)�
DATE
04* *7.00
*7.00
*7.00
A *000
237.5
08-17-79
;F 6479.
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
00-17-79 37.6
* 7 it
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
of
9.
utilities
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
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.
DATE / d �� SIGNATURE
/SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAyL�C,ONDITION%
DAT AqLP4��
OFFI Al-
Required
L
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
-
PERMIT NUMBER
cg)�
DATE
04* *7.00
*7.00
*7.00
A *000
237.5
08-17-79
;F 6479.
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
00-17-79 37.6
* 7 it