1979, 10-25 Permit: 79-6709 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT M 79-6 70 y
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE/0`-2,5— 79
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS 0.4'* *7.O O
1. 0 P'''.4,
LEGAL DESCRIPTION — SEE ATTACHED *7.0 0
Lo
LOT BLOCK SUBDIVISION PARCEL NUMBER/S *7.O O U
2.
OWN R a PHONE E * Q O O
3 ADDR S ZIP Required Set Backs in Feet 6 7 a 8
North !SouthEast (West 1 0—2 5-7 9
CONTRA PHONE Size of Parcel Zone Classification
c_:&__--cie— 2 6,479,
4' ADDRESS [/ ZIP Type Const. Occupancy Sprinklered
CT)-- . / v Eves ❑No ❑ Req'd.
DESIG PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area I Basement Area Garage Area I Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
TYPE No.Baths No. Floors No. Rooms Rec. Room
EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. 0 MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK ) <-8. t —.)--%--- g--) CLIC— cfg....t...1— ( "-..-----a------ rt---- FEES COLLECTED
VALUATION Source GAS ELECT WATE 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.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. ��11/�''/�1 Plan Check
Env.Health Y�J"'— '
SEPA CCD
Planning
W
2
Fire Marshall Mobile Home cc)
r
Co. Engineer Other (Specify)
Utilities *2�
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /a,.2..,-5---79 �Z THIS BECOMES A PERMIT.
DATE OFFICIAL/If/a/4GD � — ! ,' �', q 4* 7, n ,
APPROVED FOR ISSUANCE
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