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1979, 09-21 Permit: 79-4505 FurnacePLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES JOB ADDRESS 1. F $6 /5- /%aLot- �..� 2. OWNS / 3. TO/ N SG/o2/v/r4 ADDRESS 4E_VC- 6/C4 � / - /Ala/.-.-,5oe, -ve 4'a 4. ADpRESSfre /a1 7/ O /�vF/' a 4- s,rrd &t -e, 44 DESIGNER BLOCK SUBDIVISION /4.T. LEGAL --,DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S PHONE qa6 —67o3 ZIP 79o%O‘, Required Set Backs in Feet North 'South East 'West 5. PHONE Pa g"—.2/ao Size of Parcel 1 Zone Classification ZI P 97a /G Type Const. Occupancy Spnnklered Oyes ONo 0 Req'd. PHONE Valuation 1 Building Area in Sq. Ft. ADDRESS ZIP OWL Area I Basement Area ( Garage Area Storage CHANGE OF USE FROM 6. TYPE 7, OF WORK TO Split Entry Split Level Rancher O NEW O BLD. ❑ ALT. ❑ PLMB. ❑ AD N. ❑ MECH: ❑ RPL. O M.H. ❑ MVE. O POOL 0 OTHER No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Recd. Not Req'd. DESCRIBE WORK 8 /,v•rrec/ Gas t i#s(— ce. VALUATION 9. Source of Utilities GAS ELECTRIC WATER SEWER 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 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 construction. DATE 7 -/ $ - 79 SIGNATURE DEPT. SPECIAL APPROVALS REQ'D. RECD. Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL CONDITIONS: l/ 2j '—/ Ji .J/ J / tpt/ YojZ-ic `' /Oa, aOC 'TGC a S %-Naf-AAO r DATE /-1-7/OFFI C IAVJdS6r"� "fir'✓ APPROVED FOR ISSUANCE FEES COLLECTED Single $ Building Plumbing Mech. P%PB Plan Check SEPA Mobile Home Other (Specify) yoo G, o !J TOTAL s,QC �G N PERMIT NUMBER 79 -,1SoS DATE 9-..Z1 -79 04* *1200 * 1200 17) * 12008 E *Q00 0 45Q42 09-21-79 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BCOMES A PERMIT. 09:H21.9- 7.9 4.5 0,5 2 * 1.2 0 0; 2. CC O w r1