1979, 09-21 Permit App G79-4489 Gas 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
JOB ADDRESS'
/
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLO K
UBDIVISION
PARCEL NUMBER/S
2.
OWNE
PHONE
a
3.
-yys
ADD 55
ZIP
Requiretl Set Backs in Feet
North South East West
CO CTOR
PHONE
Size of Parcel Zone Classification
_
4.
A
ZI
Type Const.
Occupancy
Sprinkleretl
cDRESS
L. Q
om^ / 7
❑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 En[ry
Split Level
Rancher
6.
TYPE El NEW El ALT. EKD'N.
L,�f
❑ RPL. 11 MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7
�A
OTHER
,
WORK El BLD. ❑ PI-MB.IGMECH:
❑ M.H. El POOL
CERTIFICATE
Req'd.
Rec'tl.
Not Req'tl.
of EXEMPTION
8
DESCRIBE WORK
/ 7G--J-e�
cCJ
FEES COLLECTED
VALUATION Sourc
GAS
ELECTRIC
WATER
SEWER
of
vv /
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 st(o O local law regulating construction or the
performance of construction.
I Plumbing
DATE /�2`%/oSIGNATURE_ v Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. I Plan Check
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
10
DATES --/-1/ OFFICIAIrf�f/% o1 R/N
SEPA
Mobile Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDAI
THIS BECOMES A PERMIT.
09-21-79
PERMIT NUMBER
DATE 27
04* *14.00
*14.00 N
+14.000
E *000
44R8;p
09-21-79
a 6479.
448'9 *14.00°