1979, 09-14 Permit: 79-4040 FurnacePLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
S— f!% y, LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK ISUBDIVISION r PARCEL NUMBER/S
2.
OWNER PHONE
3.
ADDRESS ZIP Required Set Backs in Feet
lie 1�ifldl�lr North South East West
CONTRACTOR PHO E Size of Parcel Zone Classification
�v�;✓�-cam � .� ,���7`1
4' D RESS ZI �7 _ Type Const. Occupancy Sprinklered
12—P, ,q- � i� ❑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
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE El NEW ALT. ElAD'N. El RPL. 1:1MVE.
7, OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. I Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK /� q ,e� 1
8• //f /� L ��L �I/[i �1G's 1vq eq? , -7v /O G O00 FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. 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
performance of construction. Plumbing
DATE 'i�PO SIGNATUR _ Mech. ell��
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities TOTAL $yG
Zone Clearance
WHEN MACHINE VALIDATE
SEPA Checklist THIS BECOMES
%
BECOMES A PERMIT.
DATE_ _ OFFICIAL I`19 1. f�� r 'I
DATE
) 1PERMIT NUMBER
79 — Aleq 60
04* *9.00
*9,00
*9:005,
E * 0.0 0 18)
403.92
09-14-79
;9 6.479.
SPACE,
L
*9. 01