1979, 11-13 Permit: 79-7617 Mechanical Fixture PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 11/12/79
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 4 * * 1 2.0 0
JOB ADDRESS S. 1219 Skipworth LGAL DESCRIPTION — SEE ATTACHED * 1 2.0 0 n
1. .
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 2.0 0 v
2. B *0,00 U
OWNER PHONE
Ron Stipe
3• 7 b 1.b ZIP Required Set Backs in Feet
ADDRESS Same
North 'South 1East West 1 1 — 1 3-7 9
CONTRACTOR C & M Heating Pit482 4O7B Size of Parcel Zone Classification
2 6479.
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
N. 3003 Crestline 99207 ❑Yes ❑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
011 gas
6.
No.Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF 0 OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. CI PLMB. [/MECH: Cl M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK
8. Install Conversion burner FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of Alii:.^:X
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 o local law regulating construction or the
Plumbing
performance of construction.
11/12/79 GZaA66 a�
DATE SIGNATURE_ / Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health 100N BTU input o
80M BTU input SEPA I--
w
W
Planning cl_
1 inch pipe for 10 Feet . Mobile Home z
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist / THIS BECOMES A PERMIT. r
DATE ///' 0- FICIAL 11 - 13 -79 761.7cl * 12, 10 ° ~
APPROVED FOR ISSUANCE -