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1979, 12-03 Permit: 79-8648 Wood Stove
PLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (609) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES JOB ADDRESS 1. f`o. 4501 131c0Ab LOT BLOCK SUBDIVISION 2. 3 4. LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S 5. OWNER ADD ESS -5oo-- if=r—>er into COYRRfv ri P_HONE rD PHONE ADDRESS DESIGNER ADDRESS ZIP PHONE ZIP Required Set Backs in Feet NorthSouth East West Size of Parcel Zone Classification Type Const. Occupancy Sprinklered ❑Yes ❑No 0 Req'd. Valuation Building Area in Sq. Ft. DWL Area Basement Area Garage Area Storage CHANGE OF USE FROM 6. TYPE 7. OF WORK TO Split Entry Split Level Rancher 111<i EVV ❑ ALT. 0 /9D N. 0 RPL. 0 MVE. 0 BLD. 0 PLMB. G MECH: 0 M.H. 0 POOL 0 OTHER No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Rec'tl. Not Req'd. 8. DESCRIBE WORK fI /9 VALUATION 9. Source of Utilities GAS ELECTRIC 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 onstruction or the performance of construction. DATEFeC ,t 977 - SIGNATURE DEPT. SPECIAL APPROVALS REQ'D. REC'D. Env. Health 1 Planning Fire Marshall 'Co. Engineer Utilities Zone Clearance SEPA Checklist sl d , ' SPEC I CONDITIONS: DATE AP" •TTjT�rr; OR ISSUANCE FEES COLLECTED Single $ Building Plumbing 7.00 Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 1 PERMIT NUMBER 7% -SS02, DATE 04* *7.00 *7.00 tri *7.006p 6 6 *000 86478 1'2=03-79 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 12 0 3:-7t91 8'6 4:8 Z #70,0 DATE.REMARKS , . Es©ONDI OF', BalePECTIOV10. • ^ \ --1 41 • / 1" ;r‘ , • • - - (.7-1 i C. Final Inspection INSPECTED BY. B S -02-X� * 0 0 3 • ct 4 0 0