1979, 11-06 Permit: 79-7358 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
JOB ADDRESS
//6/9
E -,LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUB DIVISION PARCEL NUMBER/S
OWNER
3. ADDRESS
CO
Koh
4' ADDRE S�
DESIGNER
5. ADDRESS
CHANGE OF USE FROM ITO
6.
f
ZIP
PHONE
ZI
PHONE
ZIP
TYPEI41 El OTHER
NEW ElALT. ElAD'N. ElRPL. 1-1MVE.
7. O F ) 6
WORK ❑ BLD. ❑ PLMB. C(MECH: ❑ M.H. ❑ POOL
DESCRIBE WORK
s. a ct ti`
Requirea Set t3acks In reet
Source
North South
East West
Size of Parcel
Zone Classification
Type Const.
OccupancySprinklered
❑YesF-1 No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
DWL Area
Basement Area
Garage Area
Storage
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
Split Entry
Split Level
Rancher
man construction.
Plumbing
4�aAA
SIGNATURE 6hLtkttj,w'
No. Baths
No. Floors
No. Rooms
Rec. Room
SPECIAL CONDITIONS:
DEPT. `' REQ'D. RECD.
CERTIFICATE
Req'd.
I Recd.
Not Re(
of EXEMPTION
SEPA
Planning
FEES COLLECTED
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
of
9,
Utilities
Single $
1 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
man construction.
Plumbing
4�aAA
SIGNATURE 6hLtkttj,w'
Mech.
DATE f1 1)"Q!7
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. `' REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDA'
THIS BECOMES A PERMIT
SEPA Checklist
6- I 7
DATE OFFICIAL
.I
APPROVED FOR ISSUANCE
DATE
N1 1 PERMIT NUMBER
4�--7 5-C6
04* *7.00
*7.00
735.7-2
11-06-79
-4 6479,
IS SPACE,
U .,
00F