1979, 10-12 Permit M79-5893 Furnace, Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
LOT
2.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
BLOCK
r�f (_p o� / d / � �'- � /
SUBDIVISION/
OWNER
3
)0 r1'1 r
CONTRACTOR
4.
5.
6.
ADDRESS
ADDRESS
DESIGNER
ADDRESS
(1'F_ N FC(i/Ai f
CHANGE OF USE FROM
TYPE
7. OF
WORK
TO
PHONE
ZIP
PHONE
/./ 1-la 7,
ZIP
olao 7
PHONE
ZIP
XNEW ❑ ALT. D AD'N. ❑ RPL. ❑ MVE.
❑ BLD. Cl PLMB. MECH. ❑ M.H. ❑ POOL
ESCRIBE,WORK
VALUATION Source
of
9
Utilities
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North
Size of Parcel
Type Const.
South
East West
Zone Classification
Occupancy Sprinklered
DYes No ❑ Req'd.
Valuation Building Area in Sq. Ft.
OWL Area Basement Area Garage Area
Split Entry
Split Level
Storage
Rancher
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
GAS
ELECTRIC
LECT//R I C
X.
I1/27/).
WATER
SEWER
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
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. i/
d
DATE /It // Z,17C SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE/el—A"?' 7 /OFFICIALjICa_ fl- 1 ✓l ��
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
M
PERMIT NUMBER
DATE /(l/79
04* * 1 3.00
*13.00 N
* 1 3.006
g *000
589.2
10-12-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
INCPF'TfI?
APPROVED FOR ISSUANCE
10=12L79 5'89.35
*13.0,0°