1979, 09-07 Permit: 79-3542 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT / Z
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675SATE 'ei l7
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAK -.4 COPIES /
04 * * 1200
JOB ADDRESS /9‘ G � //�a LEGAL DESCRIPTION - SEE ATTACHED * 1 2.0 0 U
1.
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 2 0 0
2 OWNERg PHONE A * 0,00 U
3. • - _-___A . ,,,,,..9-,5-7,, 3 5 U 1
ADDRES ZIP Required Set Backs in Feet
jV 7 ? a % % 46 North (SouthEast (West 0 9-0 7-7 9
CONTRACTOR PHONE Size of Parcel Zone Classification
L-12,61- ..40 • - 53f14 7C 2 6479,
4' ADDRESS / ZIP ) / Type Const. Occupancy Sprinklered
7 Jr._'/J -,2/^ / 9,i-D( ❑Yes ❑No ❑ Req'd.
DESIGNER `/ PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No.Baths No. Floors No. Rooms Rec. Room
TYPE 0 NEW 0 ALT. VireDa/ ❑ RPL. ❑ MVE.
7, OF ❑ OTHERCERTIFICATE Req'd. Recd- Not Req'd.
WORK ❑ BLD. ❑ PLMB. 0 M.H. 0 POOL
of EXEMPTION
I DESCRIBE WORK � /�� FEES COLLECTED
8. �1� g-eeA e_-' ��4/ . 1-0---z1 /
VALUATION Source GAS ELECTRIC WATER SEWER
of rj�/ X'
9. Utilities /� l� 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
Plumbing
performance of construction.
DATE SIGNATURE /cx
MecV.�yi,� "�
SPECIAL APPROVALS SPECIAL CONDITIONS: ��
DEPT. REQ'D. REC'D. Plan Check
Env.Health
0
SEPA C
F-
C.
Planning — C.
0
Mobile Home C.
Fire Marshall 2
Co.Engineer Other(Specify)
Utilities d0
TOTAL $
Zone Clearance
SEPA Checklist
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PE79RMIT. 1 (�
DATE?*7). OFFIC ` —�I" 7 s O l — J J ( L * 1 U n
APP,OV 0 OR ISSUANCE _