1979, 09-11 Permit: 79-3741 Gas ConversionPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES ā PRESS HARD TO MAKE 4 COPIES
1.
2.
3.
JOB ADDRESS
LOT
BLOCK
607
SUBDIVISION
OWNER
IT . Lvj.mit
175-3
LEGAL DESCRIPTION ā SEE ATTACHED
PARCEL NUMBER/S
ADDRESS
N 601 Lee l.7L
ZIP
Required Set Backs in Feet
North 'South lEast (West
CONTRACTOR F. 7)74' ADDRESS _ l Y .^t 00 3 II1E3 / 0///ye.
PHON
gr -N07 8
Size of Parcel 1 Zone Classification
zNza 7
Type Const.
Occupancy Sprinklered
CYes 0No 0 Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
D W L Area
Basement Area 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
0 NEW
D BLD.
0 ALT. 0 AD N. 0 RPL. 0 MVE.
ā PLMB. IX MECH: 0 M.H. 0 POOL
$ DESCRIBE WOR t45 / g
0 OTHER
22J e4NeR,5761,0
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd. -
Re 'd.
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 gr.nting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or 1. al law regu :ting construction or the
perfor . - e of cā¢, struction.
/0 7
DA
SIGNATURE
DEPT.
'SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
PSP& /11 yo
DATE I OFFICIA
APPROV'r 'OR ISSUANCE
FEES COLLECTED ' '
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
DAT EI.
PERMIT NUMBER
"374-(
6 id 7j
04*
*600
*600 N
*6006
*Q00 S
37412
09-11.79
3 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS a COMES A PERMIT
0Y'71117 7 3.7422 *6,0!02