1979, 10-24 Permit: 79-6619 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 77
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 4 * * 1 2.0 0
JOB ADDRESS
1. , LEGAL DESCRIPTION — SEE ATTACHED * 1 2,0 0 i7
_
LOTe�' / '-'2' 5 Vey c /� I--BLOCK SUBDIVISION PARCEL NUMBER/S * 1 2.0 0'6
2. E * 000 S
OWNER PHONE
3. Y' eIA_ M0 `� eke'! —e3/ 7 661.82
ADDRESS zip47Required Set Backs in Feet 1 0—2 4—7 9
2 / North 'South East West
CONTRACTOR PHONE Size of Parcel Zone Classification 6 4 7 9,
4 Ai il, .,--42.LI 1--) ,,, f i :-?k. f d e , .g--3't--'i '7. ,' ADDRESS / ',/ ZIP Type Const. Occupancy Sprinklered i'
c5 /o 5 717—e "'-l. r _ f2OE Elves ❑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 ❑ NEW El ALT. El AD'N. ❑ RPL. El MVE.
7. OF / ❑ OTHER
WORK ❑ BLD. CI PLMB. MECH: CIM.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DE CRIBE WORK
8. yt `, Tit i/ A v"71 "VV C'71' �et, 62 FLA__ ---,l ard t'- FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities 1-.'
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 a 0
Mech. / -
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. + , Plan Check
Env.Health f DO , 1.�(//q_/��y QI NIS SEPA
Planningpl. 01 /I i — c...)7Hl rL
Mobile Home
Fire Marshall
Co. Engineer Other(Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist Allb. I 7HIS�FCOESA /� MIT. J ��' 1.9 ( I a
U 44' * 12. 1
DATic .cZ2:43"FFICI �r
APPROV . FOR ISSUANCE -