1979, 08-20 Permit: 79-2460 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
1.
2.
3.
JOB ADDRESS
EGA . DESCRIPTION - SEE ATTACHED
LOT
OWNE
BLOCK
ADDRESS
SUBDIVISION
PHONE
9,2? -63v-7
ZIP
PARCEL NUMBER/S
Required Set Backs in Feet
North
South
CONTRt;CTOR
4• �ADDRESS /
DESIGNER
2 e
PHONE
3).51/
Size of Parcel
East (West
Zone Classification
ZI P
Type Const.
Occupancy Sprinklered
❑Yes ❑No El Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW ❑ ALT. AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. : ❑ M.H. ❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
VALUATI ON
9.
Source
of
Utilities
GAS
V,x
ELECTRIC
d
WATER
SEWER
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
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.
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D_ REC'D.
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
l
DATES —/ T OFFICIAL -RA"gc��` o 7 k
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
6 -2L/ )
DATE az-C1 �G/ /9-7
l l* *1200
* 1200
* 12008
E *0.00
245.9
08-20-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS8ECOME,S A PERMIT.
L2UU y9 246.02 *1200°1
APPROVED FOR ISSUANCE —