1979, 10-23 Permit: 79-6566 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB/ DDRESS
LO BLOCK S8DIVISION
Vr 2oo
LEGAL DESCRIPTION - SEE ATTACHED
OWnE
3. Ar 1 X11Nc
ADD
E
Zy;o,
PARCEL NUMBER/S
Required Set Backs in Feet
North
South
East !West
CONT liCAr/,
4. /QQ�V�L��//�11 V
ADDRESS
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
OWL Area
Basement Area
Garage
Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7, OF
WORK
L7 NEW ❑ ALT. D AD ❑ RPL. ❑ MVE.
0 BLD. 0 PLMB.MECH: 0 M.H. 0 POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd
Rec'd.
Not Req'd.
8.
DESCFjIBE WORK
OoD
VALUATION
9.
13LJ=24r if v61 lvv
Source GAS
of
Utilities
ELECTRIC
WATER
SEWER
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 (1c. . r-23) ]c17 i -
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D_ REC'D.
Env. Heath
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
APP 'T!S'r-, FOR ISSUANCE
FEES COLLECTED
Single S
Building
Plumbing
OJ
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
DATE
04*
*7.00
*7.00 t
6565A
10-23-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THISf COI E ANIMIT.
6156.6g *7.00
O J
a�