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HomeMy WebLinkAbout1979, 11-26 Permit: 79-8287 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 1. 2. JOB ADDRESS E. V f1 LAY 1111 try LOT BLc-16315U SUBDIVISION LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S OWNER 3 DUN(MI Ail ELMS' ADDRESS E. 9319 VA I.g wA CONTRACTOR 4. A 1 P-) 4R 4 1t4c PLu MB I Nf� ADDRESS (A).8o4' PgoI/IDXNc DESIGNER 5. ADDRESS PHONE ZIP 9920G Required Set Backs in Feet North 'South [East (West PHONE 32,7-53/0 Size of Parcel Zone Classification ZI P 479205' Type Const. Occupancy Sprinklered Elves ENO ❑ Req'd. PHONE Valuation Building Area in Sq. Ft. ZIP DWL Area I Basement Area Garage Area Storage CHANGE OF USE FROM 6. TO Split Entry Split Level Rancher TYPE 7. OF WORK D NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE WORK 8. 6 Ace-,___AbLeicE VALUATION 9. l ►d S714,LLA`1I0N Source of Utilities GAS ELECTRIC WATER SEWER 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 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. DATE II—�2' (o 7 Cf SIGNATURE S — DEPT. SPECIAL APPROVALS REQ'D. REC'D. Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL CONDITIONS: I75 sr a -T14 DATE OFFICIAL APPROVED FOR ISSUANCE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) O6 TOTAL $ / "XX PERMIT NUMBER 7?- c?287 DATE 04* *9.00 *9.00 N *9.006 B *Q00 8 828.62 11-26-79 2 6479. I— U — w 0 cn WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMESA PERMIT. 11-2'6-79 828.7 *9.00°17-1