1979, 10-17 Permit: 79-6171 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT M — C.:=,1
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
jr.
1. 77 s /3 C, -k.:' , ;V . LEGAL DESCRIPTION — SEE ATTACHED * 1 200 N
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 2 0 0 6
2 O ER { L PHONE E * 0.0 0 S
ADDRESS Required Set Backs in Feet
�; '`1 , a„ j*;t North `South East IWest 1 0- 1 7-7 9
C NTRTOR t P NE Size of Parcel Zone Classification
\n-x----4 4f-. 5Zyl__ '. V'VC,L""--' G'n'4.1 CPS
ApDRESS `� ZIP Type Const. Occupancy Sprinklered
AME
. tij IY/C-�y,, ❑Yes ❑No ❑ Req'd.
DESIGNER l•�` PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area I Basement Area( Garage Area I Storage
CHAN OSE FROM TO Split Entry Split Level Rancher
6. ' No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ R ❑ MVE.
7, OF ❑ OTHER Req'd. Recd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. U'MECH: ❑ M.H. ❑ POOL CERTIFICATE
of EXEMPTION
DE IBE WORK.,.n...{,;, 1 FEES COLLECTED
8. 9-tli)
VALL A ."fit -,--f�I{ Source j GAS ELECTRIC r WATE J SEWER
I 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
co)
DATE ) 0—. 17— 7/ SIGNATOR .VIAC .j �' ''I -v-v.`-.-'/ Mech. p.,
SPECIAL APPROVALS SPE ONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
E
Env.Health Ilp _ O
�.vt . ' SEPA U
Planning
L.Li
Cl)
c .,5, .t•L"-L',°^ Mobile Home
Fire Marshall 2' D
Co. Engineer Other (Specify)
Utilities TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS,BECO F,. ,A PERMIT.
likp/ ,./- 10 — I / —1 1 1 0 * 1 2Q 0 a �
DATE 1° i 11 OFFIC • �Q��S`
APPROV 5 FOR ISSUANCE —