1979, 08-30 Permit: 79-3159 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
JOB ADDRESS (�
ISO 4/
1EGA2 DESCRIPTION — SEE ATTACHED
2.
3.
LOT
BLOCK
SUBDIVISION
OWNER 4eetti...4.7zzety
PHONE
1026 -6,4‘55 -
PARCEL NUMBER/S
ADDRESS
ZIP
Required Set Backs In Feet
North 'South
East
'West
CONTRACTOR/�AC��'A,
4' ADDRES �� V�
PHONE
,534/-4‘97C
Size of Parcel
Zone Classification
ZIP
99ao6
Type Const.
Occupancy Sprinklered
Dyes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
' DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT. ,❑A��DppN. 0 RPL.
❑ PLMB. L% MECH: 0 M.H.
DESCRIBE WORK ✓✓��
8.
0 MVE.
0 OTHER
0 POOL •
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
VALUATION
9.
Source
of
Utilities
GAS
XXXX
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 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 br local law regulating construction or the
performance of construction.
DATE SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
79
DATE Q i / - OFFICIyJ�
APPROVCrU FOR ISSUANCE
Recd.
Not Redid.
FEES COLLECTED
Single $
Building
Plumbing
Z.41471
°Le
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /01
8
PERMIT NUMBER
7t- 3`S9
DATE 3G /1179
0 *1200
* 1200
* 12008
A *000
31582
08=30'-79
3 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08c-30!,7.9
3'15;95 *1200aj
CC
U
W
0-
Z