1979, 07-31 Permit: 79-1296 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
1.
2.
3
4.
5.
JOB ADDRESS
LOT BL6/ c(
CK7 b i�l�Y� -
MSI ON
OWNER
n2/ai
LEGAL DESCRIPTION —_SEE ATTACHED
P ONE
?S-io7o
PARCEL NUMBER/S
ADDR SS
CQgIT RACT
/4/4//D
P
ZI99g,y
Required Set Backs in Feet
North 'South East 'West
AD KESS
?ft7io
DESIGNER
PlOrgi00
zliOa2/6
Size of Parcel - Zone Classification
Type Const.
Occupancy Sprinklered
OYes 0No 0 Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
IrNEW 0 ALT. �0 AD N. 0 RPL. 0 MVE.
❑ BLD. 0 PLMB. IG MECH: 0 M.H. 0 POOL
duct
8.
ESC` I Wee_ is t L2 G� V
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
I hereby certify that I have read and examined this applica ion 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 -- V` - 7 f SIGNATURE
DEPT.•
SPECIAL APPROVALS -
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
Air
KA
SPECIAL CONDITIONS:
.
DATE
OFFIC
APPRO
OR ISSUANCE
FEES COLLECTED •
Single $ 1'06
Building
Plumbing
Mech. 1.00
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL
$700
PERMIT NUMBER
-n - 12 9c -
DATE
04* *7.00
*7,00
*7006
A *000 4
129.5a
07-31-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07=31-79
129.62
*7.000
0
O
W
d