1979, 10-05 Permit: 79-5391 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT /V 7q-,53gi
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE `O"\_ "79
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
04 * * 12.00
JOB ADDRESSmay,
/�j� Y ( / LEGAL DESCRIPTION - SEE ATTACHED * 1200 N
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 ZOO v
2.
OWNER ,ryPHONE E * 0 0 0 0
3. &M406,14'
"I 612
40 �L'�''/l,,y.��+ jA7/66.0539,0
TRESS'',r� ,/► ZIP Required Set Backs in Feet
t 1 y/ 1,5 rv- V North 'South East (West 10 05—79
COQ RACT'OR ��/ PHONE Size of Parcel Zone Classification
4. I / ; yozo
,l„�.Q , CbV �C.c 2 6479,
4Dr. ESS %� 4., ��;�`', /_ ZIP Type Const. Occupancy Sprinklered
G )Y/r1`,// ❑Yes ❑No ❑ Req'd.
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.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. 0 AD'N. ❑ RPL. ❑ MVE.
7, OF ` ❑ OTHER i
WORK
El BLD. 0 PLMB. &ECH: El M.H. 1=1 POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DEA
�R I B E WOR \ `
8. IC— 4T)j .�.— c J Gi: • /_O,Coo
J/ V,0 ,/�- ,� l N_, FEES COLLECTED
VALUATION Source GAS (f(�ELIECTTRrW`ATLE•R/ (•`/C( SEWER
of �(/�
9. Utilities /Y�
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 c nst uction. ` ' / 9 Plumbing
DATE /0 1 SIGNATURE .� ..--,A . A_ / 'a isMech. i�
SPECIAL APPROVALS SPECIAL CONDITIONS: I
DEPT. REQ'D. RECD. ^� 1/ Plan Check
Env.Health „/ _ /
Cil I-
SEPA
0
Planning / 1/ — w
d
Mobile Home
Fire Marshall
Co. Engineer CV/ , . q
aCYj
ia
1.-I�.' Other (Specify)
]`
Utilities -0TOTAL $ / g
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist / 7q G��(,[,,r/�J�,/./�"y ( As' THIS BECOMESE [ A''PERMIT. } "� (� (�
DATE/d I" OFFICIALR��Z�L'I_ "` "i1 i�_ _` 1 0 - 0 5 - /f9 .i 3 9. 1 * 1 2,U U 1 F-
APPROVED FOR ISSUANCE