1979, 08-17 Permit: 79-2396 Wood StoveP'_AN 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
LOT
1. E, 1 I/9 t3cot�F
2. ict
.00K SUBDIVISION
/ ccrB/N AbD/, foN
OWNER
3, „Anne -Fs d MkR./ F,F1SSL.
ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S 17552- O 133
PHONE
F . I FYLcf BZ'GNe,� �,R NLAtl s
CONTRACTOR
4. MF—
ADDRESS
ZIP
99a1(P
PHONE
Required Set Backs in Feet
North 'South East (West
Size of Parcel Zone Classification
ZIP
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZI P
DWL Area I Basement Area
Garage Area Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
lk NEW ❑ ALT.r❑/,�AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. L'7 ivIECH: ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
DESCRIBE WORK
WOcn 5Tt' IJF
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 construction or the
performo'nce of construction.
DATE / / 7 ?' SIGNATURE,/!%
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE—! f !� 0FFICIAL�b7.r?Yni/4./�d�1�
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
OV
TOTAL $'7 X
M
PERMIT NUMBER
71_ 2-3%
DATE AUS 1' 1'171
04* *7.00
*7.00 67)
*7,006
B *G00
239,5
08-17-79
g 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS COM A E MIT.
(�$-1 239.62 *7,00°F
DATE
RECORD OF INSPECTIONS
Final Inspection
REMARKS INSPECTED BY
gvAa'
08-ja-1a
52621
*1005Z
*1'00