1979, 09-13 Permit: G79-3942 Gas 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
JOB ADDRESS
'AL DESCRIPTION — SEE ATTACHED
LOT I BLOCK SUBDIVISION PARCEL NUMBER/S
TYPE ❑ NEW
7, OF
WORK ❑ BLD.
MALT. ❑ AD'N. ❑ RPL.
❑ PLMB. ❑ MECH: ❑ M.H.
❑ MVE.
❑ OTHER
❑ POOL
equired Set Backs In Feet
OWNER
u•.Yy—mac.
//�9
PHONE
3.
Ctlu
Type Const.
ADDRESS
Sprinklered
ZIP
❑Yes ❑No ❑ Req'd.
I
aluation
Building Area in Sq. Ft.
CONTRACTOR
DWL Area
PHONE
Garage Area
Storage
Split Entry
{/
Rancher
4.
ADDRESS
ZIP
No. Baths
Q
No. Rooms
Rec. Room
DESIGN R
PHONE
5.
Req'd.
Rec'd.
Not Req'd.
of EXEMPTION
ADDRESS
I
ZIP
CHANGE OF USE FROM
TO
6.
0--l-X
CC
TYPE ❑ NEW
7, OF
WORK ❑ BLD.
MALT. ❑ AD'N. ❑ RPL.
❑ PLMB. ❑ MECH: ❑ M.H.
❑ MVE.
❑ OTHER
❑ POOL
equired Set Backs In Feet
orth South
East West
ize of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
I
aluation
Building Area in Sq. Ft.
DWL Area
Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
No. Baths
I No. Floors
No. Rooms
Rec. Room
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
of EXEMPTION
I
DESCRIPE WO K
$. -�L7 • �K !/ Yrs .V�� L/ CZt 4`.T�' C FEES COLLECTED
VALUATION Source GA ELECTRIC WATER SEWER
of
9. Utilities
Single $
1 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
c�/'•�—%
DATE Lel- SIGNATURES Mech. %
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
�1 C
DATE �OFFICI
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /;�-
PER UMBER
DATE z _
04* *1200
*1200
* 1 2.00
A *0.00
3941
09-13-79
-4 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS��C011I~77,A �TMIT. �
2zzd
*12.000
s
Final Inspection
DATE REMARKS INSPECTED BY
06-12-'J6
40
x1;0(;
i