1979, 10-04 Permit: 79-5286 Furnace"LAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509)456-3615
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARb TO MAKE 4COPIES
Joe ADDRES
S
C' -?,6LEGAL DESCRIPTION -SEE ATTACHED
1. G
PARCEL NUMBER/S
z.
OWNER j
ApDflE55 ZIP epulrep Set Backs In FeeEast SoutM1 CONTO P1N o1 Filter Zone ClesilllcatlOn
4. ., _..____..
ger107 I _. _ I I 0vee ONo O Facie.
5'
ADDRESS
ZIP
ANa
Basement Area
Garage ANa
Storage
CHANGE OF USE FROM
TO
lit Entry
SPIR Level
Rancher
6.
❑NEW ❑ALT. D'N. ❑RPL.
OF I�
WORK 11 BLD. ❑PLMB. MECH: ❑ M.H.
❑ MVE.7. ❑OTHERERTIFICATE
❑POOLf
L-No.Batni
No. Floors
No. Room3 Rec ROOTTYPE
EXEMPTION
ReqO.
Raco.
of aq6
DESCRIBE WOR
e. Q9
FEES COLLECTED
VALUATION source LJOUSA,
ELECTRIC WATER SEWER
Or
9. Uont es I
Single S
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 per it does not pre me
Building
to give authority to violate or cancel the provisions of
perfor Ca Of CO sLnlCtlOn.
any other state or al law re9alat 9 constructio r the
Plumbing
DATE
SIGNATURE
04
Mach.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ -0. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Other Strecifyl
TOTAL $ �F 110
Fire Marshall
Co. Engineer
utilities
Zone Clearance
WHEN MACHINE VALIDAI
TH ISIR�COIa1Ej APE,f2MIT.
sEPA CneckllstDATE
OFF L
PER IT NUMBER
)I
DATE
04e +9.00
*900 to
19.00
B *00C
52a52
10-04-79
2 6479.
528661 as9.000