1979, 11-07 Permit M79-7423 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
3.
JOB ADDRESS
BLOCK
LOT
ADDRESS
NTRACTOR
DRESS
f S--4) () Cc,'?
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JVCUI V IJIVIN
DESIGNt ,
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
❑ NEW
O BLO.
DESC IBE WORK
8. V -- -a
VALUATION
9.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH:
Sourc
of
Utilities
❑ RPL.
❑ M.H.
GAS
PHONE
PHONE
PHONE
❑ MVE.
O POOL
0 OTHER
ELECTRIC
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North South
Size of Parcel
Type Const.
Valuation
DWL Area
Split Entry
No. Baths
WATER
CERTIFICATE
of EXEMPTION
SEWER
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse sine, 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 oi'construction.
DATE /— 7 9
DEPT.
Env. Health
Planning
SPECIAL APPROVALS
REC'D. REC'D.
SIGNATURE
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE OFFICIAL
Zone Classification
Sprinklered
Oyes ❑No 0 Req'd.
Building Area in Sq. Ft.
Garage Area
Occupancy
Basement Area
Storage
Split Level Rancher
No. Floors No. Rooms Rec. Room
Req'd. Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
M
DATE //-- 7- 7
PERMIT NUMBER
79 - 7 4-223
04* *1200
* 1200
* 12006
E *000 0
74222
11-07-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11 0 /: 7.9
742,35 *'12,00a-
APPROVED FOR ISSUANCE