1979, 09-25 Permit: 79-4655 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT �91'7
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NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE / �� /r!
APPLICANT: COMPLETE NUMBERED SPACES - PRESS FARD 1/O MAKE 4 COPIES
JOB ADDRESS
1 s /moi• ) �, C . - A. LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVI ION f� PARCEL NUMBER/S
2. 04 * *900
OWNER PHONE
3. Gf�t.Y' l -� AA - ph /ea.-- ga2 'a$6a *9,00 N
ADDRESS ZIP
/' Required Set Backs in Feet *.9,O O V
5 o.'fyt ,e-- 71'g 0 North 'South East 'West
CONTRACTOR 0 PHONE Size of Parcel Zone Classification E * O.0 0 U
4. Nt?Ye v H•eo. "t-n fL (7.0 zf3y•' t 7 7 46548
ADDDRESS,?c/1 ZIP /" Type Const. Occupancy Sprinklered
=
-L'�v r —e -- -t t ler *6 Eves ❑No ❑ Req'd. 09-25-79
DESIGNER 7 PHONE Valuation Building Area in Sq. Ft.
g 6479, _
5' ADDRESS ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No.Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. 0 AD'N. ❑ RPL. ❑ MVE.
7, OFCIOTHER
WORK 0 BLD. ❑ PLMB. MECH: CIM.H. I=1POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE
�K �/
8. ,.i;� Q— ci a, OO 0 FEES COLLECTED
V LUATION a� Source GAS 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
0r0-
DATE SIGNATURE_ Mech. qSPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
tY
SEPA o
Planning — U
LU
a.
Mobile Home (,)
Fire Marshall z
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
DATE OFFICIAL 0 "9 _2 7'_7'"94 6 5' 5 o *9 a o 4
APPROVED FOR ISSUANCE -