1979, 10-08 Permit: 79-5477 Chimney PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
02 * * 1000
Jo DD 7 s�0 �Ni v LEGAL DESCRIPTION — SEE ATTACHED
1. * 1 0.0 0 Mn
( (/
LOT BOCK SUBDIVISION �y�- -1e ,,�� PARCEL NUMBER/S * 1 O.O O U
2. 7 �l7 q 1 V�' - rAg _ - I � v'.�
WNER P ON ��.,• E * O O O 0
3. ' V1 • FO w ' - -so �`✓y 547,6
ADD ESS 'V O Z Required Set Backs in Feet
��a 8 �D� North 'South [East (West 1 0 0 8-7 9
CONT A TRt PHONE Size of Parcel Zone Classification
4. 2 6479.
ADDRESS ZIP Type Const. Occupancy Sprinklered
Eyes ENo ❑ Req'd.
J.
DESIGNER ,. 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 M/
No. Baths No. Floors No. Rooms Rec. Room
L� NEW ❑ ALT. ❑ AD'N. ❑ RPL. D MVE.
7. OF / ❑ OTHER
_
WORK BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8 N N ' �� w , FEES COLLECTED
9 AA UATJON Source GAS ELECTRIC WATER SEWER
IfOU of
Utilities
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included G`
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building 10
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.iion. d Plumbing
DATE PI — I — 7 7SIGNATURE � Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. fl4 r O F Iv v '4 I Kms'( Plan Check
Env. Health rr v I,/
z
SEPA D
Planning Uw
(1-
Mobile
Mobile Home co
Fire Marshall Z
Co. Engineer Other(Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist / ^ - c THIS BECOMES A PERMIT.
DATE 6-7q OFF
• / _ 1 0'-0 8 — /� '7 7 5 `F !. /'7
Z * 1 0. 0 0'2 f
{ f APPR., D FOR ISSUANCE -