HomeMy WebLinkAbout1979, 10-01 Permit: 79-5037 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
1.
2.
3.
JOB ADDRESS
11 7
LEGAL DfcSCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWNER
Cary Y cit n S
ADDRESS
Sa
PHONE
ZIP
79"g c> 6
Required Set Backs in Feet
North 'South East 'West
5.
CONTRACTOR
Dt'C?o
ADDRESS
.5-0
DESIGNER
a. t! -n/ Cc
.Tre n�
ADDRESS
PHONE
531/ "i9
ZIP
Size of Parcel Zone Classification
PHONE
ZI P
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
TO
Type Const.
Occupancy
Valuation
DWL Area
Split Entry
Basement Area
Sprinklered
Oyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Split Level
❑ NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
❑ BLD. 0 PLMB. 1d'MECH: ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
CERTIFICATE
of EXEMPTION
Req'd.
Storage
Rancher
Rec. Room
Rec'd.
Not Req'd.
D CRIBE WORK
8. �C ,��4 L_���r/ t.,< -
VALUATION
9.
Source
of
Utilities
L {.'7Lte..dQ_
GAS
ELECTRIC
WATER
SEWER
I hereby certify that 1 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
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.
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE 1O/iI/ n- OFFI e
l/ APPROV FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
7
TOTAL $
of
DATE
PERMIT NUMBER l
04* *7.00
*7.00
*7.006
B *000
503.6
10-01-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOME$ A PERMIT.
97. 5.03,75
*7.00.°