1979, 10-03 Permit: 79-5212 Furnace, Heat PumpPLAN iVUMBER
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
1.N B � e�s5oscl t ,V• 230/
2.
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
a JocV4PS
^-'A2.oGl'5yy R Th No? so/
PHONE
926 —012`7
PARCEL NUMBER/S
ZIP
Required Set Backs In Feet
North 'South East 'West
CONTRACTOR
4. No/ic.�,uPa3:94Q 11 vela/
Gro Fihy4
5.
DESIGNER
PHOE
533; at76 3
Size of Parcel Zone Classification
Type Const.
Occupancy Sprinklered
❑Yes DNo 0 Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
ONNEW 0 ALT. 0 AD N. 0 RPL. 0 MVE. 0•
OTHER
0 BLD. 0 PLMB. 0 MECH: 0 M.H. 0 POOL
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.
9.
VALUATION
Source ELECTRIC WA R
of
Utilities
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 correc . 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 -ti
construction.'7
DATE 3 -79 % SIGNATURE_ '^' i2f
DEPT.
SPECIAL APPROVALS
REO'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilltles
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE/c 3 / 9OFFICIAL /QiC/ i/Y\WYV✓V��
APPROVED FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
)3.44
PERMIT NUMBER
DATE /O 3-7j
04* *1300
*1300 Lz
521.'1B
10-03-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES PE MIT. d * ID
10?0.3'Ix.7' 521.22 13. pin F-1