1979, 12-11 Permit: 79-8939 Furnace PLAN NUMBER APPLICATION/PERMIT ,i PERMIT-7NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT T�'le `R /v',l J��
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /u//1//
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 4 * * 1 8.0 0
JOB ADDRESS l ri �-
1 C[/�� 4///5 � t''././t. (1
� � liA- ', _ t LEGAL DESCRIPTION - SEE ATTACHED * 1 0 0 0 t6
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 8. 0 0 y
2. E
3. OWNER c e t ir. _ /L1�' ! LJ,7L� 7i7J .. �7, t,
8 9 3 8
ADDRESS ZIP Required Set Backs in Feet
• 4//6 /_},,L, -6. hC.J North 'SouthEast (West 1 2- 1 1 -7 9
CONTRA.TOR PH E Size of Parcel Zone Classification
-[n •,�-��-C? //f7—//7e g 6.4 7 9.
4. ADDRE�S , ZIP Type Const. Occupancy Sprinklered
�7 di n 7c 7 � e>
Oyes ❑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.
TYPENo. Baths No. Floors No. Rooms Rec. Room
❑ NEW ❑ ALT. ❑ AD'N. 0 RPL. 0 MVE.
7. OF ���rr ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. ��Itt MECH: ❑ M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK
$ t,j._ti z/ g.7,,,,._... �L �, FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
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 or local law regulating construction or the
performance of construction. Plumbing
DATE SIGNATURE_ Mech. A''
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health /e—
! j"
rr.
SEPA o
Planning —
0
Mobile Home v,
Fire Marshall
Co. Engineer Other (Specify)
Utilities l`�
TOTAL $/
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT. _ 1 r.. r C __I
` I l 'C�. 1 � J * 1 'J, uW f
DATE/�//�/ / OFFICIAL y 2 —1 1 `- i
l APPROVED FOR ISSUANCE -