1979, 10-30 Permit: M79-6994 Wood StovePIAN 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
1. `. f7Z&3LEGAL DESCRIPTION — SEE ATTACHED
2.
LOT BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWNER n
3 'ZJ#_,LGtd-7.C/ 1 a t-71
ADDRESS
CONTRACTOR / 7LP �LOOwy A CRL2 d�
C
4.-4•16t,"7"ute _
ADDRESS
ol��.G�-VLi.�
DESIGNER
PHONE
9
ZIP
'/90/1
Required Set Backs in Feet
North 'South (East 'West
PHONE
Size of Parcel 1 Zone Classification
5' ADDRESS
ZIP .
Type Const.
Occupancy
Sprinklered
❑Ves ❑No ❑ Req'd.
PHONE
Valuation I Building Area in Sq. Ft.
ZIP
D W L Area
Basement Area 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE 0 NEW
7. OF
WORK 0 BLD.
❑ ALT.
❑ PLMB-
❑ AD'N.
MECH
❑ RPL.
❑ M.H.
❑ MVE.
o POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
8.
9.
DESCRIBE
+--WORK
VALUATION
urce
of
Utilities
GAS
ECTRIC
WATER
SEWER
I hereby certify that I have read and examined this applica ion and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correc . All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. he granting of a permit does not presume
to give authority to violate or cancel the provisions of any othg state o local law re sting constructton or the
performance of construction.
DATE rAi `-79
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIA ONDITIONS:
) 4-00-79'
DATE OFFICIAL/k//
��'`�
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 7
66
PERMIT NUMBER
79— 6991
DATE/Gi0-79
04* *7.00
*700 ts
699.31
10-30-7A
1 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'1;0y50'' 79' 6'949.142 *Z002.0