1979, 10-17 Permit: 79-6187 Furnace !PLAN NUMBER APPLICATION/PERMIT M PERMIT NUMBER
I' SPOKANE COUNTY — BUILDING CODES DEPARTMENT y - (421E37
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
04 * * 7,00
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED * 7,0 0
1 * 7,00
4 su nl E,Q�.A
LOT BL C SUBDIVI N PARCEL NUMBER/S Y
2. E �,
OWNER PHONE * 0 0 0
3. 3-M EnfrE'RPRISE S 9 '4-277 6 1 6
ADDRESS ZIPj� Required Set Backs in Feet
C..9611 SPRA .U SPOKI J IP9V E 06 North South East west 1 0- 1 7 7 9
CONTRACTOR r PHONE Size of Parcel Zone Classification
A-1 HEATI,U 4 AIR/COAT)_ '9-96D _ 2 6 4 7 9,
4' ADDRESS�! ` �f /�,�` ZIP Type
Type Const. Occupancy Sprinklered
E.46 WE:� .SPolekK)E` %9 o ❑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.
TYPE No. Baths No. Floors No. Rooms Rec. Room
KNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK
El BLD. ❑ PLMB. MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. I P ST/kL.L �'S"kill FU RAO ACE 4 `�N WORK FEES COLLECTED
VALUAT ON Source GAS ELECTRIC WATER SEWER
of
9. Utilities XX 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
DATE SIGNATURE_ Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check I
Env. Health
z
SEPA 4 o
(--
Planning —
Planning — w
a.
Mobile Home V)
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $ 7./36
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS1B.ECOME$ jj A REr.RMIT.
DATE �`- I OFFICI 'I
APP' FOR ISSUANCE -