1979, 07-24 Permit: 79-933 Gas FurnacePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK
FEES COLLECTED
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
1.
JOB ADDRESS
j 'Zrz
)F %,f' fd ,0
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LEGAL DESCRIPTION -SEE ATTACHED
WATER
LOT
BLOCK
SUBDIVISION
of
PARCEL NUMBER/S
2.
I
9.
Utilities
OWNER
PHONE
3.
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
o v ,r
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
RE
performance of construction. G��i/
IP
Required Set Backs in Feet
Mech.
7-
,�/7�r ,/—
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/j
�'r
7 '}
a✓
Plan Check
-2-
/ l�� a[(�
/
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
[--]yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
I Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
_
Gam'
� f
Sf luAG,
TYPENo.
�NEw
ALT. ❑ AD'N. ❑ RPL.
❑ MVE.
Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
❑ OTHER
❑ BLD.
11PLMB. ElMECH: ElM.H.
El POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
X�
of EXEMPTION
DESCRIBE WORK
FEES COLLECTED
8 C ILI .v 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
performance of construction. G��i/
Plumbing
DATE SIGNATURE./�
Mech.
SPECIAL APPROVALS
I
SPECIAL CONDITIONS:
nFaT RFnIn aFrin
Plan Check
Env. Health
Planning
Fire Marshall
Co. Engineer
tilities
Zone Clearance
SEPA Checklist
DATOA I OFFIC
n 1C rnn soot iA ninr
SEPA
Mobile Home
OthOth r� )
K
TOTAL $
DATE
PERMrT NUMBER
04* * 1 4.00
* 1 4.00
B *0.00 n
9313
07-24-79
2 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07-24-79 93.455
*14,00°
.. _. ..... .... .... ' w "'0 x"5..4 D
a::.,F
04SPECTIONS
.. REMARKS
BY
j Too
Fawn wo.
raC191" 110.
I;. rmy entify that I am
mcking my = 942 equiprant i na l ti within my own building and,
vurtiasv i';�vtify that I knew" x s ltr._ make W1,193 entira instgAlation LU eMPU-nnad
with the Gas Code as well au all -,.-aquftr.-d teats for tightneas, pro"T input,
maL---
�:C,Ocv f= o�! upon eemplut','xn o. thia -17nsUllatian ancl b-lafavva .11A01
and -uifniassed d4vmdu—
Notary Public for ltzhca Sezte cof
ReStOzz in spokana