1979, 09-10 Permit: G79-3634 Furnacer
PLAN 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
1. L'ZTe?
2.
OWNER
LOCK
! ,/
SUB
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
PHONE
ADDRESS
ti
CO RQCTOOR
4.
ADDRESS
1/9 2
DESIGNER
5. ADDRESS
/(9_
/7'eee
ZI P
Required Set Backs in Feet
North 'South
East (West
PHONE
Size of Parcel Zone Classification
PHONE
Type Const.
Valuation
Occupancy Sprinklered
Elves ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZI P
DWL Area I Basement Area
Garage Area 1 Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
L1 NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
❑ RPL.
CH; ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. / ,v i 7-417P� L i/
VALUATION
9.
Source
of
Utilities
yCl'/A<i
Ga4S/
ELECTRIC
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. RECO.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
STO - yaw 4
DATPJ /�-7 / OFFICIA
FEES COLLECTED
Single $
Building
Plumbing
Mech
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
/ PERMIT NUMBER
72/ 79-3653
DATE q --/C)----7
04* *1200
* 1200 to -
* 12006
E *0.00
363.32
09-10-79
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09-10-79 365.42 *12.002H