1979, 10-26 Permit: 79-6829 FurnacePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WOR g
g 3
PERMIT NUMBER
APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
Imo,
VALUATION
LEGAL DESCRIPTION - SEE ATTACHED
DATE
111,1705
WATER
SEWER
9.
LOT
BLjSUBi5`I`VIS1'?5—NK
-A
PARCEL NUMBER/S
2.
C7 • c'D
Single $
7* ® , 0 -ID
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
OWNER y
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
PHONE
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
3.
performance of construction. Plumbing
�j
DATE SIGNATURE 1Lkft!L- '""`-'�
ADDRES$r�
//'' )
�
SPECIAL APPROVALS SPE IAL CONDITIONS:
ZIP
Required Set Backs in Feet
`�'
SEPA
North South
C0NT-RACTOR
Co. Engineer Other (Specify)
PHONE
Size of Parcel
East West
Zone Classification
Zone Clearance
WHEN MACHINE VALIDATED
IN
SEPA Checklist THIS BECOMES A PERMIT.
DATE OFFICIAL ,j 0',(� i1 �
4'
APPROVED FOR ISSUANCE
AD P�ESyC .-
ZIP
Type Const.
Occupancy
Sprinklered
%5 e'
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
�(
TYPE IXl NEW
lll"`111
❑ ALT. ❑ AD'N. ❑ RPL.
❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
�,
OF
�(
❑OTHER
WORK ❑ BLD.
❑ PLMB. 1'�`.MECH: ❑ M.H.
l
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
of EXEMPTION
DESCRIBE WOR g
g 3
PERMIT NUMBER
VALUATION
Sourc
DATE
ELECTRIC
WATER
SEWER
9.
0 y o -d
-A
�- "7 C9'D
K�
C7 • c'D
Single $
7* ® , 0 -ID
DESCRIBE WOR g
g 3
FEES COLLECTED
VALUATION
Sourc
GAS
ELECTRIC
WATER
SEWER
9.
of
Utiliti s
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
�j
DATE SIGNATURE 1Lkft!L- '""`-'�
Mech. —�
SPECIAL APPROVALS SPE IAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED
IN
SEPA Checklist THIS BECOMES A PERMIT.
DATE OFFICIAL ,j 0',(� i1 �
APPROVED FOR ISSUANCE
0
e—
U
— W
Cl
U
Z
PACE, I
682.62 *7,,00a�