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1979, 12-17 Permit: 79-9178 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUM R SPOKANE COUNTY — BUILDING CODES DEPARTMENT 6" -16‘ J ) 7C6 NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE / a " --/161 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES /1 JOB RESS 04 * * 1 2,00 1. J3.3j a Joopvr-A- LE3AL DESCRIPTION — SEE ATTACHED * 1 2.0 0 LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1200cx..' 2. PH SS "Iaa as-Q40 0 E * 0 0 0 3. ADDRESS9177$ Z Required Set Backs in Feet 'IN-CU q9c .1(o North 'South East (west i 2- 1 7-7 9 NTRACTOR PHONE Size of Parcel Zone Classification 4. nJ ,' 3a..5-4,16- R 6 U 7 9, ADglRESS Type Const. Occupancy Sprinklered IL acy-/ �a*,..i- Sao 7 Eyes ❑No E Req'd. DESIGNER PHONE Valuation Building Area in Sq. Ft. 5' ADDRESS ZIP DWL Area Basement Area Garage Area Storage — CHANGE OF USE FROM TO Split Entry Split Level Rancher 6. TYPENo. Baths No. Floors No. Rooms Rec. Room ❑ NEW ❑ ALT. ❑ AD'N. 0 RPL. 0 MVE. 7. OF 0 OTHER - WORK 0 BLD. 0 PLMB. 0 MECH: 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd. of EXEMPTION DESCRIBE WORK `� 8. /Le illi r'� 71�v' n 2O 4-..}1-yea iut L , vU'- ti--. FEES COLLECTED VALUATION SourceAS ELECTRIC WATER 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 law regulating construction or the performance of construction. ) Plumbing DATE !//t /� `9SIGNATUR /f y .4! t1 i//r'"�✓ Mech. 4tg,00 SPECIAL APPROVALS SPECIA CONDITIONS: Oe DEPT. REQ'D. REC'D. Plan Check Env.Health CVu.S, 3-C SEPA Planning — C. tL Fire Marshall tf�y Or 0-DO Mobile Home i/ v Co. Engineer / 1/ Other(Specify) Utilities // // ��l�C /7 TOTAL $\a,O0 Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist ar-Net.444,07%.„- APPROVED THIS BECOMES A PERMIT. 7 } I} ODATE I-'�/J7/ OFFICIAL I ..' .' —% y� (} 1 ! * L� Ul FOR ISSUANCE _