1979, 11-21 Permit: 79-8262 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
1.
2.
3.
JOB ADDRESS
711 9
LOT
BLOCK
SUBDIVISION
OWNER
I/ -j�''j 2\�
V�`jl f
AC�� DDRESS
�tH_
CONTRA
4' ADDRESS
TOR
DESIGNER
5' ADDRESS
PHONE
ZIP
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
LTJ NEW ❑ ALT.
❑ BLD. ❑ PLMB.
PHONE
ZIP
TO
❑AD'N. ❑ RPL. ❑ MVE.
k,/MECH: ❑ M.H. ❑ POOL
DESCRIBE WORK
or
VALUATION
9.
Source
of
Utilities
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
performance of construction.
DATE 1� °2/
GAS
ELECTRIC
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North
South East
Size of Parcel
Type Const.
Occupancy
IWes
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
DWL Area
Basement Area
Split Entry
No. Baths
Building Area in Sq. Ft.
Garage Area
Split Level
CERTIFICATE
of EXEMPTION
WATER
Storage
Rancher
SEWER
examined this application and have read the "NOTICE" provisions included
to be true and correct. All provisions of laws and ordinances governing this
whether specified herein or not. The granting of a permit does not presume
the provisions of any other state or local law regulating construction or the
SPECIAL APPROVALS
DEPT. REQ'D.
REC'D.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIALICONDITIONS:
DATE
/7
OFFIC
APPRO P FOR ISSUANCE
Rec. Room
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $
,i�d
DATE
PERMIT NUMBER
-
';4* *7,00
*7.00
*7.006
E *0.00 8
82612
11-21-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11-21-79
826.2' *ZOO°