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1979, 11-09 Permit: G79-7534 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 1. 2. 3. 4. JOB ADDRESS LOT BLOCK UADIVI/ION / 61h aLtt/ LEGAL DESCRIPTION — SEE ATTACHED 5. OWN ciwN EB- �j�,-���/�� arms E 14f 6olt (494-00 Tg -A:6 RESSOM' ( n j DESIGNER �,/J1� /j(�\��{�J 9 - ZIP PARCEL NUMBER/S Required Set Backs in Feet North 'South East (West PHONE z4 9ao PHONE Size of Parcel 1 Zone Classification Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. Valuation (Building Area in Sq. Ft. ADDRESS ZIP DWL Area I Basement Area ( Garage Area Storage CHANGE OF USE FROM 6. TO Split Entry Split Level Rancher • TYPE NEW ❑ ALT. 0 AD N. ❑ RPL. 0 MVE. 7. OF 11 WORK ❑ BLD. ❑ PLMB. ECH: ❑ M.H. 0 POOL DESCRIBE WORK 8.\r Ac 10)gyc)p C +S 1 50C VALUA I N Sourc GAS EL RIC of 9. Utilities 0 OTHER No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. I,1 11 „ k FEES COLLECTED WATER SEWER 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.j DATE I t/6/ I tr1 SIGNATURE' SPECIAL APPROVALS DEPT. REQ'D. REC'D. Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist Cali,- Jam" SPECIAL CONDITIONS: - I5' 1" - ac 71- 3 Single $ Building Plumbing Mech. 4 DATE OFFICIAL Plan Check SEPA Mobile Home Other (Specify) TOTAL PERMIT NUMBER — s3y DATE 04* * 1 7.00 *17.00 7533' 11-09,-79 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 11-097=7'9 753.42 *,17.00°� L