1979, 08-15 Permit: 79-2256 FurnaceNUMBER
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
LOT BLOCK UB ISI�
LEGAL DESCRIPTION - SEE ATTACHED
A DJ7IJt E*/S�1
S��
31j AC—JP1,4",
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East IWest
CO TRACTOR
4. AESS Cly
DESIGNER
5. ADDRESS
PHONE
Size of Parcel Zone Classification
PHONE
Type Const.
Valuation
Occupancy Sprinklered
Oyes ENo ❑ Req'd.
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area I Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
If7
EW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
❑ BLD. ❑ PLMB. It9 MECH: 0 M.H. 0 POOL
DRIB r
8.
VALUATION
9.
Source
of
Utilities
GAS
0 OTHER
ELECT
No. Baths
No. Floors
No. Rooms
Rec. Room
WATER
CERTIFICATE
of EXEMPTION
SEWER
Req'd.
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 "l 91`�`7itJ
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Heath
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
ti C. / u G Fel !LE.6 C ,L L A/ -
DATE
OFFICI
APPP n
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. $(2_0_
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ t i d 0
PERMIT NUMBER
DATE
04*
A
22552
08-15-79
6479,
*7.00
*7.00 rn-
*7,006
*0,00 0
c
_ c
WHEN MACHINE VALIDATED IN THIS SPACE-
THIS
PACETHIS BECOMES A PERMIT.
08-15-79 2 25.65)
*7.00