1979, 11-29 Permit: 79-8480 HeaterPLAN 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 p S 2 e
LOT BLOCK SUBDIVISION
•
2.
3.
4.
5.
OWNER
ADDRESS
CO NTR
ADDRES
DESIGNER
Ci2LtA (6.4,4_0fi
LEGAL DESCRIPTION - SEE ATTACHED
ZIP
PPHO8NE /f7 /
ZIP
7 993-07
PHONE
PARCEL NUMBER/S
Required Set Backs in Feet
North (South East (West
Size of Parcel I Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area r Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
•
TO
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
❑ ALT. 0 AD N. 0 RPL. 0 MVE.
❑ PLMB. cS MECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
• CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
9.
DESC IB ORK
$ 2,/ l i.y.
VALUATION
Source
of
Utilities
_ 1-a247-) -, (tjr ln4ti C/� °
WATER 0 'SEWER
GAS
ELECTRIC
1 hereby certify that I have read and examined this applica ion and have read the "NOTICE" provisions included
''ion 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 N
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL
-�NDITION V
y..
-r a0
cOINFig, LIG, -1014 -P r-137 2No
223- o2_, (6- I -go)
----- 3 in..
DAT
/'7 OFA
II
AP' : r fl OR ISSUANCE
FEES COLLECTED
Single $
Building
1.00
Plumbing
Mech. -
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
G
PERMIT NUMBER
DATE
03* *15.00
* 1500 N
* 15006
E *000 8
‘847.9a
11-29=79
3 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'11:-12 9'-r7.9. 8148.05 *45.0020
O
U
W
Z