1979, 10-31 Permit: 79-7047 Furnace ',PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
.I SPOKANE COUNTY — BUILDING CODES DEPARTMENT H 761 - 76'i/7
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /Dl 77
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS �� LEGAL DESCRIPTION — SEE ATTACHED 0 G. * *7.0 0
1. //�.776 ,;zo 3 * 7.00
LQT I BLOCK SUBDIVISION PARCEL NUMBER/S *7.0 0 v
2.
OWNER
V`��y],r1 / T PHONE B '1 * 0,0 0 S
3
ADDRESS
ear-yS /O 6c /tc/.- , ZI —`'S V6 Required Set Backs in Feet 7 0 y,6
OC4A/ W' c.//c•:.✓.✓` 5 cil,e.ve w,e r7‘421?S; North 'South East 'West 0-3 � -79
CONTRACTOR PHONE Size of Parcel Zone Classification
4. A'f./I Q u 4 i 77 /fec� 1`,,v�; /..-c- Y is --,�foe 2 611.79,
ADDRESS ZIP Type Const. Occupancy Sprinklered
E" /7. `J/0 1,4,d,4,.vi( Saci4e,,,-, C414 ???./L ❑Yes ❑No ❑ Req'd.
DESIGNER �/ PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area I Basement Area Garage Area Storage —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
TYPE No. Baths No. Floors No. Rooms Rec. Room
\
NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. 0 PLMB. 0 MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK /, G. �C
8. J.^✓..rte , 44,47 /� 7 yc' / c A. FEES COLLECTED
VALUATION Source I 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 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. if00
SPECIAL APPROVALS SPECIAL CONDITIONS: "k` r "/eel
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA P
Planning _ LU
d.
Mobile Home C/D
Fire Marshall Z
Co. Engineer Other (Specify)
utilities TOTAL $ 2 ed
Zone Clearance
p WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /i —.3/—7 / • tTHIS BECOMES A PERMIT. /�
DATE OFFICIA L.ilii A OF i 1 j U ties 1 Q
„ '{
— / / �? '.- , / '. * 7, 0 0 O }-
APPROVED
APPROVED FOR ISSUANCE _