1979, 10-30 Permit: 79-6992 FurnacePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK
DATE
8. , ,51-1 LL J� ie44-7 r-alp/V 4e-1—, rccocv��ct rccr
APPLICANT:
COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
1.r
JOB ADDRESS
j l3C)G�
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE'.' provisions included
LEGAL DESCRIPTION - SEE ATTACHED
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
LOT
BLOCK
SUBDIVISION
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
Plumbing
performance of construction.
PARCEL NUMBER/S
2.
I
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
OWNER
SEPA
Planning
PHONE
Fire Marshall Mobile Home
C IV 14115 'T
E i
Utilities
!)V j'
3.
STA IF 74
Zone Clearance
WHEN MACHINE VALIDATED
-,;z
SEPA Checklist'��//// THIS B CO
nATF144N 1)-- F
ADDRESS
ZIP
Required Set Backs in Feet
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
r v n 4 A/
<
q Z.- 33 ,,)_
a.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
ar
E 1"o / / /v/ t - 4'e- 51;7
y/-
H
�1
9 f < 4, �
Dyes ❑No ❑ 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.
TYPE ❑NEW El ALT.
1:1AD'N.
El RPL.
ElMVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
1-1OTHERRe
El BLD. F-1PLMB.
ElMECH:
1-1M.H.
F-1 POO L
CERTIFICATE
q'd.
Recd.
Not Req'd.. '
WORK
of EXEMPTION
DESCRIBE WORK
DATE
8. , ,51-1 LL J� ie44-7 r-alp/V 4e-1—, rccocv��ct rccr
VALUATION Source GAS ELECTRIC WATER SEWER
7 of �s--
9. 1 �!? Utilities
Single $
1 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
Plumbing
performance of construction.
7.
� 7 ' ""`' ��Z 1i'rrt
DATE SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED
IN
SEPA Checklist'��//// THIS B CO
nATF144N 1)-- F
PERMIT NUM ER
IAJ
0 t *7,0.0
*7.00 'Ln -
7. 0 0 101 7.001
B *0.00 n
699.1 ;S
10-30-79
2 6479.
SPACE,
699,22 *7,00