1979, 09-11 Permit: 79-3783 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 LEGAL DESCRIPTION — SEE ATTACHED
9. Utilities Single $
1 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
Plumbing
performance of construction. ��
DATE (� " SIGNATLIRE1� t� -�--� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. ' p - _ Plan Check
Env. Health .� e1�
Innn SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer Other (Specify)
Utilities
Zone Clearance
SEPA Checklist
r / If '7
DATE /11 / / �OFFICIA
DATE
PERMIT NUMBER
-75
04* *7.00
*7.00 s,
*7.0061
E
378,1
09-11-79
9 6479,
TOTAL $�
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09'-11-79 57P,
,&7nno-
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
OW R
PHONE
3.
ADDRESS 0
ZIP
Required Set Backs in Feet
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4'
ADDRESS
1
ZIP
Type Const.
Occupancy
Sprinklered
J
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE yy
❑ALT. ❑ AD'N.
1:1 RPL.
El MVE.
No. Baths TNo.
Floors
No. Rooms
Rec. Room
7,
OF
F-1OTHER
1:1 BLD.
1-1PLMB. E3MECH:
F-1M.H.
❑
CERTIFICATE
Req'd. Recd. Not Req'd.
WORK
POOL
I
of EXEMPTION
DESCRIBE WORK
8
r
FEES COLLECTED
VALUATION
So ce
GAS
ELECTRIC
WATER
SEWER
of
9. Utilities Single $
1 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
Plumbing
performance of construction. ��
DATE (� " SIGNATLIRE1� t� -�--� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. ' p - _ Plan Check
Env. Health .� e1�
Innn SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer Other (Specify)
Utilities
Zone Clearance
SEPA Checklist
r / If '7
DATE /11 / / �OFFICIA
DATE
PERMIT NUMBER
-75
04* *7.00
*7.00 s,
*7.0061
E
378,1
09-11-79
9 6479,
TOTAL $�
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09'-11-79 57P,
,&7nno-