1979, 11-16 Permit: M79-7956 Wood StovePLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
L T BLOCK SUBDIVISION
2.
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER /S
4.
OW E R,r ,r;
ADDRESS
- �j
-a4 r 67/ �c 4,44,4
CONTRACTOR
AO.DRESS
DESIGNER
5. ADDRESS
PHONE
g,:4-
ZIP
Required Set Backs in Feet
North 'South [East 'West
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ONO ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
El OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
SCRIBE WO 5K
8. N._
VALUATION
9.
E�
of
urce
Uti lities
GAS
EL TRIC
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.
DATE //'--/Z,— 79 SIGNATURF,
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D.
4
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DATE OFFICIA
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
,7Z)
Mech. /
Plan Check
SEPA
Mobile Home
Other (Specify)
$
TOTAL
PERMIT NUMBER
DATE // —79-
*7.00
*7.00
79558
11 -16 -79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
ii rib -79 795.62
DATE REMARKS
RECORD OF INSPECTIONS
Final Inspection
INSPECTED BY
elaa
11-19 —aa
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