1979, 11-06 Permit: M79-7402 ChimneyPLAN 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.
JQB ADDRESS
7-17.��'t,.�,1'-,���
LOT BLOCK SUBDIVISION
Q.
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER
3. _,f
ADDRESS 4
Ale) A7
CONTR TOR
!�2%' eaiY�&,V
4.
5.
PHONE
ZIP
7q2
Required Set Backs in Feet
North 'South (East
'West
PHONE Size of Parcel
Zone Classification
ADESS
DESIGNER
ZIP
PHONE
Type Const.
Valuation
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ADDRESS
ZI P
DWL Area
Basement Area Garage Area I Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
❑ RPL.
MECH. ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. 9 all./ 0
c.e.tGb_ �7 izi
VALUATION
9.
Source
of
Utilities
AS
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 costruction,or the
performance of construction.
DATE
DEPT.
//4/7Y
SPECIAL APPROVALS
REQ'D. REC'D.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL
NDITIONS:
//-:;- ! /
DATE
1,�GJ U
OFFICIAL' (t.L. -vL1
1
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 7
M
DATES/ -4'- '/
PERMIT NUMBER
79-- 741
04*
*7.00
*7,00 in -
740,1 2
11-06-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A P RMIT.
11'-06"-79 74Q22
*7,00°�