1979, 10-19 Permit App M79-6379 FurnacePLAN NUMBER
JOB ADDRESS
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
C) 1 LEGAL DESCRIPTION — SEE ATTACHED
OWNER
�u lv.
PHONE
i�Z
3.
ADDRESS
�`Q
ZIP
Required Set Backs in Feet
`-"I� 1. V� .S1 \
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4' ADDRESS¢¢
Type Const.
Occupancy
Sprinklered
ti ri 3C) �
CZ�IP /
f t
❑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.
No. Bath=
No. Floors
No. Rooms
Rec. Room
TYPE L1 NEW ❑ ALT. >uI yy,� AD -N. El RPL.
El MVE.
], OF
11 OTHER
CERTIFICATE
Req'tl.
Rec'tl.
Not Req•tl
El BLD. ❑PLM B. kMECH: ❑ M.H. El POOL
WORK
of EXEMPTION
DESCRIBE wo RK
FEES COLLECTED
8,
ti wC�
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
g,
of
Utilitles
X X
Single $
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
\ 1Cj1 " lA `40� �
Mech. C-' ri
SPECIAL APPROVALS - SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Utilities
TOTAL
Zone Clearance
'
WHEN MACHINE VALIDAI
SEPA Checklist // t
DATE•�OFF
THIS BECOMES A PERMIT.
1 Gall 9 _719.
PERMIT NUMBER
81 77-6;-w>77
DATE Ib -\6--7
04* *7.00
*700
*7.006
E *000 8
637.83
10-19-79
3 6479.
6'37:9= *Z00aI-'