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1979, 10-16 Permit: M79-6090 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 B ADDRESS LOT BL CK O ;14 - 2. LEGAL DESCRIPTION - SEE ATTACHED OWN E41 3. ADDRESS a�Y/ 7 CONTRACTOR 4. ADD ESS �i�L1� DESIGNER 5 ADDRESS PHONE 6Y -ZS —.ems 75' ZIP PARCEL NUMBER/S Required Set Backs in Feet North 'South lEast (West PHONE Size of Parcel Zone Classification ZIP Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ 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 q NEW ❑ BLD. ❑ ALT. ❑ PLMB. ❑ AD'N. ❑ MECH: O RPL. O M.H. O MVE. O POOL 0 OTHER No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Recd. Not Req'd. _SCRIBE WO K LL .-1 t) VALUATION 9. Source of Utilities GAS EL CTRIC 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 //)--./6 --7y SIGNATURE "2" DEPT. SPECIAL APPROVALS REQ'D. REC'D. Env. I loalth Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL CONDITIONS: DATBO & 7/ OFFICIAL,e1-1 APPROVED FOR ISSUANCE FEES COLLECTED Single S Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 7'' M DATE 44 J4' 79 04* *7.00 *7.00 *7.006 E *0100 g 60892 10-16-79 B 6479. PERMIT NUMBER 79-( 90 WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 10.-161-79 60.9.02 *7,00a1-2 DATE RECORD OF INSPECTIONS Final Inspection REMARKS INSPECTED BY JC -JP -ad PO8dt E +-00. o *a00R =100 Oct* •Soo