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1979, 10-04 Permit: 79-5295 Furnace PLAN NUMBER * . APPLICATION/PERMIT PERMIT NUMBER SPOKANE COUNTY — BUILDING CODES DEPARTMENT "1 7T -52. 9S NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /0"- 44-71 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 04 * *7.00 JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED *7,0 0 N 1. 44o W.-_ 24.147AUS *7.00 LOT BLOCK SUBDIVISION PARC€L NUMBER/S Y 2. r OWNER PHONE B *Q 0 Q 8 3. RITA WHjrE- 92 ,-/1f52 529,4 ADDRESS ZIP Required Set Backs in Feet 41/03 a- 2ND AIDE qg2-06 North 'South East (West 10-04-79 CONTRACTOR PHONE Size of Parcel Zone Classification Rai IS { E -INc 3z8-857' 2 6.479. 4' iZADDRESS ZIP Type Const. Occupancy Sprinklered w. 516* Ha14LANP "M2.,/,? ❑Yes ❑No ❑ Req'd. DESIGNER PHONE Valuation Building Area in Sq. Ft. 5. ADDRESS ZIP DWL Area 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 ❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE. 7, OF ❑ OTHER WORK ❑ BLD. ❑ PLMB. XvMECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd. of EXEMPTION DESCRIBE WORK FEES COLLECTED 8. D aer wor.X_ f =mac.,-rRt C FUR/SAcE_. VALUATION Source GAS ELECTRIC WATER 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 o .,+ .',. ordinances governing this Building type of work will be complied with whether specified herein or not. The .ranting , a pe it does not presume to give authority to violate or cancel the provisions of any other s - ;•cal -•1"-ret• atint construction or the performance of con ruction. /t - d G. Plumbing DATE C) 5/79 7 SIGNATOR, �j- ' Mech. 7 SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. REC'D. c A4_1_, Fcip-- /r,t3PECTiON T7 -4 „ 4/ Plan Check Env. Health w I7 f Y3La- /0 � SEPA CD ai Planning — ,J Mobile Home Fire Marshall Co. Engineer Other(Specify) Utilities .p0 TOTAL $ 7 X/e Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist THIS COME APE MIT. '7 ((�� (� O DATE/0-11'7q OFFICIAL AD . at- rfLl �� - '- -' l _� * ?.U U tZ F APPROVED FOR ISSUANCE —