1979, 10-29 Permit: 79-6917 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARP TO MAKE 4 COPIES
JOB ADDRESS
LOT
2.
BLOCK
i5-aD13
LEGAL DESCRIPTION - SEE ATTACHED
3.
4.
OWNER
CO
D
1 l�
Ci
AC O
R
hTLV ar211-aL,
1324 h.
ESS
DESIGNER
5' ADDRESS
6.
PHONE
OtS
(/.`"c°1` 1
ZIP
PARCEL NUMBER/S
Required Set Backs in Feet
North (South
PHONE
z ® /
PHONE
Size of Parcel
Type Const.
Valuation
Occupancy
[East (West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
CHANGE OF USE FROM
ZIP
DWL Area I Basement Area
1 Garage Area Storage
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
Cl BLD.
❑ ALT. ❑ AD'N.
D PLMB. ›L.MECH:
‘tC1IIt ❑ MVE.
❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
ESCRIBE WORK
8.
Req'd.
Rec'd.
Not Req'd.
LT
CSE, icO,Occ) ScC f T cicQ . 4- ()) Ire
m'[.[ [vim Y
VALUATION Source GAS LECTRIC WATER
of , fV
9. Utilities ,X,"
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
performance of cons/trruction.
DATE �O 1 /
t clam
SEWER
examined this application and have read the "NOTICE" provisions included
to be true and correct. All provisions of laws and ordinances governing this
whether specified herein or not. The granting of a permit does not presume
the provisions of any other state or local law regulating construction or the
SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D.
REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
/2» 15,
DATE 7^'7/ / /OFFICIA
APPRO
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
DATE
PERMIT NUMBER
79- '77
04* *1500
* 15,00
* 15006
B
*0,00
691.62
10-29-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1.0-29._7'9
.7
IA Corr T/lo