1979, 11-29 Permit: 79-8513 Wood Burning StoveALAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACE — PRESS HARD TO MAKE 4 COPIES
LEGAL DESCRIPTION — SEE ATTACHED
JOB ADDRESS
PARCEL NUMBER /S
LOT
OWNE
ADDRE
BLOCK
5U6DIVISI•N
PHONE
Required Set Backs in Feet
North South
PHONE
Size of Parcel
4.
AD
DESIGNER
ADDRESS
CHANGE OF USE FROM
Type Const.
Valuation
DWL Area
Split Entry
No. Baths
Occupancy
East West
TYPE
7, OF
WORK
❑ NEW
❑ BLD.
DESCRIBE WORK
UATION Source
of
Utilities
9.
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
performance of construction.
XDATE L�' =- 7r --
SPECIAL APPROVALS
REQ'D.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
Basement Area
Zone Classification
Sprinklered
Oyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Split Level
DATE
Storage
Rancher
No. Floors
CERTIFICATE
of EXEMPTION
No. Rooms
Req'd.
Rec. Room
Rec'd.
Not Req'd.
tll'1l�
11 ELECTRIC
examined this application and have read the "NOTICE" provisions included
to be true and correct. All provisions of laws and ordinances governing this
whether specified herein or not. The granting of a permit does not presume
the provisions of any other state or local law regulating construction or the
XSIGNATURE
FEES COLLECTED
Single
Building
Plumbing
SPECIAL CONDITIONS:
�.A
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Leix*-1-o-wCen4&.)!LUDILQ
Zone Clearance
SEPA Checklist
DATE
OFFICIAL / CAA—
APPROVED FOR ISSUANCE.
Q�
TOTAL
M
ERMIT 1P1 l �M951 3 l
Oa*
*7.00
*7.00
*7.006
E *G00 8
851.2
11 -29 -79
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
o 1
THIS BECOMES A PERMIT. z d
DATE
(
RECORD OF INSPECTIONS
REMARKS
4
b
Final Inspection
INSPECTED BY
J .1-56-A6
21'S;5-
E
0 cr