1979, 10-17 Permit: 79-6175 FurancePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
VALUATION Source GAS ELECTRIC WA R SEWER
of
9, utilities Single $
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 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 la regulating construction or the
performance of construction.
Plumbing
DATE 1 / ^ 7 `7 SIGNATURE~
Mech.
SPECIAL APPROVALS SPECT L C NDITIONS:
DEPT. RE(Q'D. RECD. Plan Check
Env. Health
r
1 7. % of l � , �..-% , /-'�•"r'`< SEPA
Planning f 1
Fire Marshall UUU Mobile Home
Co. Engineer Other (Specify)
Utilities
PERMIT NUMBER
DATE
04* * 1 2.00
1 2.00
*1200
E *0, ;n
61 7.4;p
10-17-79
2 6,479,
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE
SEPA Checklist THIS.BECOME,$ A EE,13MIT.
DATE OFFIL - _.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
1,
JOB ADDRE S
S
,�
LEGAL DESCRIPTION —SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
I
0WIVIZ
7 F
PHONE
3.
>`
ADD ESS
ZIP
Required Set Backs in Feet
North South East West
R OR
PH E
Size of Parcel
Zone Classification
,d2
4'
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF Ui
FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE El NEW
El ALT. ElAD'N.
El RPL.
1:1MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
❑ OTHER
1:1 BLD.
ElPLMB. �MECH:
ElM.H.
El POO L
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
8
FEES COLLECTED
VALUATION Source GAS ELECTRIC WA R SEWER
of
9, utilities Single $
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 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 la regulating construction or the
performance of construction.
Plumbing
DATE 1 / ^ 7 `7 SIGNATURE~
Mech.
SPECIAL APPROVALS SPECT L C NDITIONS:
DEPT. RE(Q'D. RECD. Plan Check
Env. Health
r
1 7. % of l � , �..-% , /-'�•"r'`< SEPA
Planning f 1
Fire Marshall UUU Mobile Home
Co. Engineer Other (Specify)
Utilities
PERMIT NUMBER
DATE
04* * 1 2.00
1 2.00
*1200
E *0, ;n
61 7.4;p
10-17-79
2 6,479,
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE
SEPA Checklist THIS.BECOME,$ A EE,13MIT.
DATE OFFIL - _.