1979, 07-31 Permit: 79-1338 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 7) - 1 3 v
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 4 * * 1 2 0 0
JOB ADDRESS T/ �_ * 1 ZOO Ln/$ /V t/ LEGAL DESCRIPTION — SEE ATTACHED
1 LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 2.0 0 chi
2. A * 000
OWNER PHONE
3. i/e-�'/ /�./ 600.2 /e 7;6 iri r 1 3 3 8 2
ADDRESS / ZIP p /� Required Set Backs in Feet
/foe V-/y y G� QC/t�S, 4/� /®/E+ North (South East (West 0 7—3 1 —7 9
CONTRACTOR PHONE Size of Parcel Zone Classification 2 6 4 7 9.
4. i/ .74/ (i)t,,¢/ /4' /4--ei ie'-v� i-r,G 9�-5�`a AY)
ADDRESS � / ZIP Type Const. Occupancy Sprinklered
f-/A '�10 14—do..t..z ,S'gOU'' Fc.r-e, 44-i. .'7 ,?-/� Oyes ❑No ❑ Req'd.
DESIGNER f� PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
_// No.Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW LJ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ��,�� CIOTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK CI [BLD. 0 PLMB. i ECH: ❑ M.H. C] POOL
of EXEMPTION
DESCRIBE WORK FEES COLLECTED
8. i,vs✓a/ G* r /sr S / cu,i.c'a c E' f NP cam ' 4,,,,t/G�
VALUATION Source 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
Plumbing
performance of construction.
DATE 7-3 e, ` � / SIGNATURE ir �� Mech. 3 `nom
SPECIAL APPROVALS SPECIAL CONDITIONS: v AP P 3,c7 C)
DEPT. REQ'D. REC'D. Plan Check
fit,t40/14i e I re,o vv 6r4 oeej /=444,d,e
Env.Health / cY
�� i�E' SEPA — I—
o
Planning cLo
.1
a.
Mobile Home
Fire Marshall
—
//
Co. Engineer Other (Specify)
Utilities
TOTAL $ /I, GIcY
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist -s / THIS BECOMES A�RMIT.
DATE��317 , �OFFICI� �v� 0 � 1— 5 9 >. 9 1 * 1 �l 0 i= '
' � � 7
APP'0 + FOR ISSUANCE —