1979, 09-14 Permit: G-79-3989 Conversion BurnerPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPO "ANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — pr 3S HARD TO MAKE 4 COPIES
JOB ADDRESS
LOT
2.
BLOCK
SUB TVI
Oberlin
LEGAL DESCRIPTION — SEE ATTACHED
3.
OWNER
Carl 'Bowe
PHONE
PARCEL NUMBER/S
ADDRESS
Sawe Same
CONTRACTOR
4' ADDRESS
ZI P
G & 14 Heating
PHONE
484-4078
Required Set Backs in Feet
North (South lEast (West
Size of Parcel
Zone Classification
DESIGNER
5' ADDRESS
N 3003 CeestlineK
ZIP
99207
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
ZI P
DWL Area I Basement Area
Garage Area I Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
Oil
❑ ALT.
❑ PLMB.
TO
D AD'N.
1/I EC H:
❑ RPL.
❑ M.H.
Gas
Split Entry
Split Level
Rancher
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
Install conversion burner
VALUATION
9.
Source
of
Utilities
GAS
XXXX
ELECTRIC
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 • local law egulating construction or the
performance of construction. /
DATE 9/14/79 SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
1 pipe 15'
100 BTU
OFFIC
n000ruirnzro loci IA [UPC
FEES COLLECTED
Single $
Building
Plumbing
Mechj"j��
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
DATE 9/14/79
04* *12.00
* 12,00 to
* 1200'6
B *000
398,82
09-14-79
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09-14-79
598.95 *12.002
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