1979, 07-18 Permit: 79-680 Chimney iPLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
-7, ^ 0 0
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 2 * * 1 00 0
JOB ADDRESS * 1 O O O
1. r°‘‘ 7Oc)5 �xtilb LEGAL DESCRIPTION — SEE ATTACHED
LQ-1- BLOCK SUBDIVISIONri, PARCEL NUMBER/S * 1 0.0 0
2.x'97 17 VI S FAISIK �-i'Af p �,1-JrQ2� 5 1 — I-7O' A *000
OWNER , AE
3. Q 679
ADDRESS p 20 Required Set Backs in Feet �7, � 7rNorth !South East (West 0 / - 1 8-7 9
CONT ACTO PHONE Size of Parcel Zone Classification 6.4 7 9.
4. .
ADDRESS ZIP Type Const. Occupancy Sprinklered
Elves ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area !Basement Area r 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. <13'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER CERTIFICATE Req'd. Rec'd. Not Req'd.'
WORK ❑ BLD. CI PLMB. ❑ MECH. Cl M.H. I: POOL
of EXEMPTION
DESCRIBE WORK
8. Apo 61,11N4
(' vj ri b" lb
tf.)4^r� � � iLEeL
FEES COLLECTED
irALbATION SourceGAS 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 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. Plan Check -
Env. Health
z
SEPA - o
U
Planning w
— 0_
Mobile Home va
Fire Marshall —
Co. Engineer Other (Specify)_
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist -7 THIS BECOMES A PERMIT. p
DATE/ 7 OFFICI """P-`.� O / - p0 79
- / 6 8. O Z *1
O' O ,
APPRO FOR ISSUANCE