1979, 11-06 Permit: 79-7412 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
J B ADDRESS
,., SO2v 741 aM./Ayt444-it A_
LOT BLOCK SUBDIVISION
2.
OW ER �/ •
3 �A-4t41 / - /-l.•Gi�-�-(_.dJ
AD RESS
>4, S20 741-c. Ciii. -1.n zc} kA
CONTRACTOR ,y� Q
4. Cy/.742M'/ I ,.C.L.d.Z/
AD RESS 0�i,r
VVVf •. /l n 9 rt..7�/.ed,d.-
5.
DESIGNER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
PHONE
33 -74c?S
ZIP
PHONE
4g7- / 97S
ZIP
PHONE
ADDRESS
ZIP
Required Set Backs In Feet
North 'SouthEast 'West
Size of Parcel Zone Classification
Type Const. Occupancy Sprinklered
❑Ves ONo 0 Req'd.
Valuation - Building Area in Sq. Ft.
DWL Area I Basement Area Garage Area Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
O NEW
O BLD.
O ALT.
O PLMB
0 AD N. 0 RPL. - 0 MVE.
A, MECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
R eq'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. V--Vt.O f.� Q�
VALUATION
9.
O cO & /or e)
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 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 y ocal law regulating construction or the
performance of construction.
DATE //-4 — 7/
DEPT.
SPECIAL APPROVALS •
REQ'D. REC'D.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
.ta,dcorycniCca.
SPECIAL '.i DITIONS:
// .i
// — ,g"
_h
DATE /2-6- 74,
OFFICIAL tc)/2-41 /," 1514 6
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
�J
$ iq 4
1
DATE /lv'��
PERMIT NUMBER
q--
0 4 *
-
04* *1200
* 1200 to
* 12006
B *000 8
741.1B
11-06-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1'1,='06=T9' 7'4122 *12.00°g
C
O
w
0 -