1979, 12-17 Permit: 79-9162 FurnacePLAN NUMBER :,!
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
A
DATE
s. �-- �x��C ZQ �
VALUATION Source GAS
ECT RI 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 Plumbing
performance of construction.
DATE�2--c 3 — 7 S SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
Plan Check
DEPT. REQ'D. RECD.
Env. Health SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer Q�—
Utilities -V
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATE
THIS BECOMES A PERMIT.
SEPA Checklist 1
1J-
DATE/��� OFFICIAL �j 1 / _
APPROVED FOR ISSUANCE
04* + *7,00
*7.00
*7.0061
E *0.00
91612
12-17-79
2 6479.
THIS SPACE,
1.6.2 1 *7.002 r
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 curltb
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
//
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2
OWN
PHONE
3,
ZIP
Required Set Backs in Feet
ADDRESS
North South
East West
NJ
PHONE
Size of Parcel
Zone Classification
CONTRACTOR
4'
ZI P
Type Const.
Occupancy
Sprinklered
ADDRESS
�V
❑Yes ❑No ❑ Req'd.
PHONE
Valuation Building Area in Sq. Ft.
DESIGNE
5.
ZIP
DWL Area
Basement Area
Garage Area
Storage
ADDRESS
TO
Split Entry
Split
Level
Rancher
CHANGE OF USE FROM
6.
No. Baths
No.
Floors
No. Rooms
Rec. Room
TYPE El NEW ❑ALT.
❑ AWN. El RPL. ❑ MVE.
7
OF
El BLD. ❑ PLMB.
[1 OTHER
❑ MECH: ElM.H. El POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESC IBE WO K
FEES COLLECTED
PERMIT NUMBER
A
DATE
s. �-- �x��C ZQ �
VALUATION Source GAS
ECT RI 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 Plumbing
performance of construction.
DATE�2--c 3 — 7 S SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
Plan Check
DEPT. REQ'D. RECD.
Env. Health SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer Q�—
Utilities -V
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATE
THIS BECOMES A PERMIT.
SEPA Checklist 1
1J-
DATE/��� OFFICIAL �j 1 / _
APPROVED FOR ISSUANCE
04* + *7,00
*7.00
*7.0061
E *0.00
91612
12-17-79
2 6479.
THIS SPACE,
1.6.2 1 *7.002 r