1979, 09-28 Permit: 79-4960 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 7g- L9/
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE —,:::(7- 7G`
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
04 * * 1200
J ADDRESS
1. 504 \I Le- S_Po K-faIDC LEGAL DESCRIPTION — SEEATTACHED * 12.00 n
LOT BLOCK SUBDIVISION / PARCEL NUMBER/S * 1 2.0 0 6
2.
OWNER ,`� PHONE E * 0 0 0 U
3 AD RESS 4 Required Set Backs in Feet 4 9 5.9 2
- % C-.(�' North (SouthEast (west 0 9-2 8-7 9
O TRACTOR P(-ZONE Size of Parcel Zone Classification
4. iacms i ,=,i. 44..\-- `tali" ELS ` . (i�g—:- ,1 o- ' g 6479.
ADDRESS� -
p.p Type Const. Occupancy Sprinklered
1cC1 ( V ', 1.-�hAi ll _ St'(� ��C?i<+ ..)� /Cv�) 6.-) Eyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area I 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
E NEW XALT. ❑ AD'N. E RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. KMECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
CRIBE WORK ffes�, `a°, 0 rcO 1 ..----8. 'avc,k)E Vt L - c� t' ,L c et 2 1 PLi'1C. ----) rfS 4.11 -(-) C r\ii}G;E= FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of � �)� �}} P 3 F_
9. Utilities 4�./LL1
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 gr nting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or I al law regulating c struction or the
performance of construction. Plumbing
9_ _ 79 y-
DATE , SIGNATOR �� C'�-`' Mech.
SPECIAL APPROVALS SPECI1IL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA rY
(z)
-
Planning
-
a.
Mobile Home cr)
Fire Marshall z
Co. Engineer Other (Specify) /��
Utilities ��
TOTAL $/ '
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist ' 0 THIS BECOMES} APERMIT. �} O
DATE/ -�.t�-%/OFFICIAI,.�f� 4' `-.ot, *� Q Q - U / C.�j �; * 1_ �. U,Q- j-
APPROVED FOR ISSUANCE _