1979, 10-17 Permit: 79-6173 FurnacePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
VALUATION Source AS ELECT IC WATE 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 �V" �7� ! SIGNATURE Mach.
SPECIAL APPROVALS SPEdtA ONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
�l SEPA
Planning f "
C
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities
Zone Clearance
SEPA Checklist
f �j'/ J q � P
DATE !01 / 7 OFF IAL
PERMIT NUMBER
7--�-�17
DATE
04* *1200
* 1 200
*1200
E *000 u
6172Jq
10-17-79
2 6,479.
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOM 7 A PE,�MIT.
* 1 2.'J 0
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
1.0
_ r
LOT
BLOCK
PARCEL NUMBER/S
2.
ISUBuivT�:.ION
ER
ONE
3.
n
r1 v
g7 L
ADDR
IP
Required Set Backs in Feet
North South
East West
C NTRAC� R
PHONE
Size of Parcel
Zone Classification
.-
9�d
4'
AD RIESS
ZIP
Type Const.
Occupancy
Sprinklered
`)
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE F fVl
TO
Split Entry
Split Level
Rancher
6.L
2
TYPE NEW El ALT. ElAD'N.
El RPL. ElMVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
❑ OTHER
❑ BLD. ❑ PLMB. ECH:
❑ M.H. ❑POOL
CERTIFICATE Req'd. Recd. Not Req'd.
WORK
I
of EXEMPTION
DE C IBE WORK
8.
'
FEES COLLECTED
VALUATION Source AS ELECT IC WATE 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 �V" �7� ! SIGNATURE Mach.
SPECIAL APPROVALS SPEdtA ONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
�l SEPA
Planning f "
C
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities
Zone Clearance
SEPA Checklist
f �j'/ J q � P
DATE !01 / 7 OFF IAL
PERMIT NUMBER
7--�-�17
DATE
04* *1200
* 1 200
*1200
E *000 u
6172Jq
10-17-79
2 6,479.
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOM 7 A PE,�MIT.
* 1 2.'J 0