1979, 12-18 Permit App M79-9222 FireplacePLAN NUMBER
APPLICATION/ PERMIT
VALUATION
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
GAS
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
of
Utilities
O
Single $
PARCEL NUMBER/S
2.
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
OWNER /
�(L
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
PHONE
3. /z� �£G
ADDRES
Plumbing
ZIP
Required Set Backs in Feet
O.
Z p z 1— 57 F- /
Mech.
SPECIAL APPROVALS
North South East West
CONTRACTOR
DEPT. REQ'D. RECD.
PHONE
Size of Parcel Zone Classification
4' ADDRESS
ZIP
Type Const.
Occupancy
Sprinklere0
Planning
❑yes ONO O Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
TOTAL $9
Zone Clearance
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
5.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE 1:1 NEW ALT. ElAD'N.
El RPL. ElMVE.
7, OF
❑ OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
O BLD. O PLMB. CPCI,v1ECH:
O M.H. O POOL
WORK
of EXEMPTION
I
8..� /��.`¢� !E--
FEES COLLECTED
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
9.
of
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
performance of construction.
Plumbing
DATE %Z %% SIGNATOR-���..F.�ffA4
�/
rL r'=
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
TOTAL $9
Zone Clearance
WHEN MACHINE VALIDAI
SERA Checklist
THIS BECOMES A PERMIT.
12
DATE 12^79-�'l OFFICIAL �����`
M 1 PERMIT NUMBER
7:7 -
DATE
04* *7.00
*7.00
*7.006
E *G00 8
9221a
12-18-79
3 6479.
922.26, *7.00 OF