1979, 09-17 Permit: 79-4133 Furnace PLAN NUMBER `-1 APPLICATION/PERMIT PER
Iy1J�fyUMBE{2 � -�
SPOKANE COUNTY BUILDING CODES DEPARTMENT 9 44
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 .-- A.
DATE /'
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 4 * *7.0 0
k"-- JOB ADDRESS
i LOT C'/ eAc) J" LEGAL DESCRIPTION — SEE ATTACHED * 7.0 0 5
OT LOCK SUBDIVISION PARCEL NUMBER/S B * 7,0 0 c..,
2. * 0,00 U
OWNER PHONE
3. /;P,,1 to 64/5 07V—.7/3> 4 1 3,2 2
ADDRESS3-./.5---
� r� �/) ZIP Required Set Backs in Feet
5; D/5 ...IX= ,171.24 I / e",3') North 'South East IWest 0 9— 1 7—7 9
4. ,C NTRRAACTOR j / ,L PHONE Size of Parcel Zone Classification 6 4 7 9
7/i a it 2/� ryy /Lea' / 4_ ..1-e---,e– .?„4 e:R/C�c,
ADDRESS ZIP Type Const. Occupancy Sprinklered
cl._/,7 7/0 /-b-t CP,.•✓P2 , J j3G)A-Ge e',--4 ��`/, / Oyes ❑No CI Req'd.
DESIGNER ! PHONE Valuation Building Area in Sq. Ft.
5. —
ADDRESS ZIP DWL Area I Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry I Split Level Rancher
6. I —
No.Baths No. Floors No. Rooms Rec. Room
TYPE NEW El ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK CIBLD. ❑ PLMB. JXMECH: ElM.H. IDPOOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
/ aC WORRK �J _ _ ,
8. /..4-....c✓ti" cc.,e,/ A /it it 6/..,, 14,,c /cC rt.Y✓Ca c. r" FEES COLLECTED t
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. Plumbing
DATE —10), ✓/ SIGNATURE / / /_ , ,_ c" — Mech. .,••C'2fJ
SPECIAL APPROVALS SPECIAL CONDITIONS: {-/
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA a c
tanning —
4
c
Fire Marshall Mobile Home c
Co. Engineer Other(Specify)
Utilities
TOTAL $ 2. 4'®
Zone Clearance
r WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /� THIS BECOM1E7S A PERMIT. S '7 jr'��
DATE 711��1JOFFIC 1 / f. 7.9 4 1 3, 3 2 * /, U O O f
APPRO FOR ISSUANCE —