1979, 12-05 Permit: 79-8708 FurnaceN NUMBER
APPLICATION/ PERMIT
1 SPOKANE COUNTY BUILDING CODES DEPARTMENT
�b NORTH 811 JEFFERSON /,SPOKANE, WASHINGTON 99260 / (509) 456-3675
VALUATIO Source GAS ELECTRIC WATER SEWER
of
Q, Utilities --LSingle $
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 CONDITIONS:
DEPT. REQ'D. RECD. I I Plan Check
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SEPA
Ij_, �liITPERNUM R
�iTl` ^ — '%O � 'I
DATE
04* *7.00
*7.00
*7.006
E *0.00 SO
870.72
12-05-79
2 6479.
Mobile Home
Other (Specify)
n
TOTAL $ !
WHEN MACHINE VALIDATED IN THIS SPACE,
THISIBECOMES.A PERMIT.
o
DATER-S--79OFFICIAL 1 2- 0 5 7 Y UI
APPROVED FOR ISSUANCE
i[%O �I
APPLICANT:
COMPLETE NUMBERED SPACES - PRESS'HARD TO MAKE 4 COPIES
JOB ADDRES
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
PARCEL NUMBER/S
2.
I
ISUBDIVISION
OWNER
PHONE
3.
ADDRESS
zip
Required Set Backs in Feet
North South East West
CONT ACTOR
PHON
Size of Parcel
Zone Classification
Ll
y /�/
4'
ADD SS
ZIP
Type Const.
Occupancy
Sprinklered
V
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE ❑ NEW
El ALT.
El AD'N. El RPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
❑ OTHER
❑ BLD.
❑ PLMB.
❑ MECH: ❑ M.H. ❑
CERTIFICATE Req'd. Recd. Not Req'd.
WORK
POOL
I
of EXEMPTION
DESCRIBE WORK
8.
—
FEES COLLECTED
VALUATIO Source GAS ELECTRIC WATER SEWER
of
Q, Utilities --LSingle $
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 CONDITIONS:
DEPT. REQ'D. RECD. I I Plan Check
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SEPA
Ij_, �liITPERNUM R
�iTl` ^ — '%O � 'I
DATE
04* *7.00
*7.00
*7.006
E *0.00 SO
870.72
12-05-79
2 6479.
Mobile Home
Other (Specify)
n
TOTAL $ !
WHEN MACHINE VALIDATED IN THIS SPACE,
THISIBECOMES.A PERMIT.
o
DATER-S--79OFFICIAL 1 2- 0 5 7 Y UI
APPROVED FOR ISSUANCE
i[%O �I