1979, 10-01 Permit: 79-4985 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
1.
2.
3
JOB ADDRESS
5 G �h
4 ▪ 11
LOT BLOO�� K �� V
I*.EGAL+DESCRIPTION - SEE ATTACHED
CONTRACTOR
4. ia_ jo $ZX_—
DDR SS
7.7?.Q A/ /W«cP
DESIGNER
5.
PNEO
�//
.i;lr7y;Jt/
0-9207
PHONE
987- 66/26
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
East
'West
Size of Parcel - 1 Zone Classification
ZIP CCjj
1/,7- O
PHONE
Type Const.
Occupancy
Sprinklered
Dyes DNo D 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
YrkNEW ALT. 0 AD N. 0 RPL. ❑ MVE.
0 BLD. 0 PLMB. XMECH: ❑ M.H. 17D -POOL
. 0 OTHER
No. Baths
No. Floors 1 No. Rooms
Rec. Room
CERTIFICATE Req'd.
of EXEMPTION
Recd.
Not Req'd.
DESCRIBE W
$ VALUATION
Source
of
Utilities
GAS
(cfl era
ELECTRIC
WATER
SEWER
9.
I hereby certify that I have read and examined this applica ion 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.
DAT?
SIGNATURE
FEES COLLECTED
Single
Building
/ � /))Plumbing
J 1M 2 n'%'�J / Mech.
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env: Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL C6NDITIONS:
DATE% -.2? 76 OFFICIAL/,4,4t4.1212.2
d-9
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
'9-
DATE
04* *1200
* 12005
* 12006
E *.a00 8
498.4B
10-01-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
014:01-1'-749• 498,55 *1,2,OOr2iJ-
APPROVED FOR ISSUANCE _