1979, 10-30 Permit: 79-6982 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY =11 iLDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1. S 381 j0iFr R%
LOT BLO K D VISI N
21
LEGAL DESCRIPTION — SEE ATTACHED
3.
4.
5.
6.
OWNER
SCALERO CotJST. CO.
ADDRESS
GE?'o* u PRIUCR pR.
A-1 HEAYInJQ- 4 AIijConJD
ADDRESS
E./.51J61LE
DESIGNER
PHONE
9,.-4 S
ZIP
PARCEL NUMBER/S
PHONE
y'9-957/
ZIP
po�
%oiog
PHONE
ADDRESS
CHANGE OF USE FROM
ZIP
Required Set Backs in Feet
North 'South East (West
Size of Parcel - Zone Classification
Type Const. Occupancy Sprinklered
❑Ves ❑No 0 Req'd.
Valuation Building Area in Sq. Ft.
OWL Area I Basement Area Garage Area Storage
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
XiNEW 0 ALT. 0 AD N. 0 RPL.
0 BLD. ❑ PLMB. MECH: 0 M.H.
❑ MVE.
0 OTHER
❑ POOL
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. IIJLST"ALL o/o Wt.J S` uRnIACES 4 ..JUC WoRiVAt
of XX
9. Utilities
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 or local law regulating construction or the
performance of construction.
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
//fir{/� ;),ICS77C)---r°
DATE ��l �"Y /T OF
A FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ TOO
DATE
M
3a /779
04* *7.00
*7.00
*7.000
B *000
698,1
1075.0-79
6474
PERMIT NUMBER
7q -0.797 -
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1.0130'=7'9. 69&2Z *7.00
OF
aH