1979, 09-17 Permit: 79-4135 FurnacePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK FEES COLLECTED
8. Xv ,194-c
VALUATION Source GAS ELECTRIC WATER SEWER
of � �•�4
9. Utilities
Single $
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 Building
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. Plumbing
DATESIGNATUR�s="' Mech. ,�a
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTAL $ ��
Zone Clearance
WHEN MACHINE VALIDA'
SEPA Checklist 1 THIS BECOMES A PERMIT
DATE �� 79 0FF11 a" _
PERMIT NUMBER
_71
- (3
DATE
04* *9.00
*9.00
to -
9,
B *0.00
41342
09-17-79
-4 6479,
SPAt:F_;
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB DDRESS
7,41 �� /��. �
LEGAL DESCRIPTION —SEE ATTACHED
LOT
BLOCK
PARCEL NUMBER/S
2.
I
ISUBDIVISION
OWNER
PHONE
It"f"F4V ell 7 i✓41Ei< ,
3.
ADDRES�Ss
ZIP
Required Set Backs in Feet
,rte lVi
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4.
ADDRESS
ZI
Type Const.
Occupancy
Sprinklered
laZ— 44071y'
�
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE ❑ NEW ALT. ❑ AD'N. ❑ RPL.
❑ MVE.
7,
OF
❑ BLD. ❑ PLMB.MECH: ❑ M.H.
❑ OTHER
❑POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK FEES COLLECTED
8. Xv ,194-c
VALUATION Source GAS ELECTRIC WATER SEWER
of � �•�4
9. Utilities
Single $
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 Building
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. Plumbing
DATESIGNATUR�s="' Mech. ,�a
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTAL $ ��
Zone Clearance
WHEN MACHINE VALIDA'
SEPA Checklist 1 THIS BECOMES A PERMIT
DATE �� 79 0FF11 a" _
PERMIT NUMBER
_71
- (3
DATE
04* *9.00
*9.00
to -
9,
B *0.00
41342
09-17-79
-4 6479,
SPAt:F_;