1979, 10-26 Permit: 79-6824 FurnacePLAN NUMBER Y
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 JOB ADDRESS ( LEGAL DESCRIPTION -SEE ATTACHED
a`
LOT BLOCK 5 B IVISIO PARCEL NUMBER/S
pWy��
PHONE
VA124JATION
Source
GAS
ADDR,(�jSS
ZIP
Required Set Backs in Feet
�J
3
1 ! 0
North South East West
COl>kTRACTOR `.
PHONE
Size of Parcel
Zone Classification
9,
Utilities
4' A RES
ZIP
Type Const.
Occupancy
Sprinklered
�j
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
Elyes [—]No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
performance of construction.
Plumbing
5. ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
Env. Health
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF // 1:1�y OTHER Req'd. Recd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. MECH: ❑ M. H. El POOL CERTIFICATE
of EXEMPTION
PERMIT NUMBER
/19fict — �(
DATE
04* *7,00
*7.00 N
68232
10-26-79
6479,
DESC "EWORK a
ry
FEES COLLECTED
VA124JATION
Source
GAS
ELECT IC
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
performance of construction.
Plumbing
DATE SIGNATURE "-"�"-"„�`
Mech.
SPECIAL APPROVALS
SPECIAL NDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT. D n c.
DATE OFFICIAL
0..,-,.,2 6 e �! G
APPROVED FOR ISSUANCE