HomeMy WebLinkAbout1979, 11-27 Permit: M79-8402 Wood StoveNot Req'd.
PERMIT NUMBER
7`1—d`D,
'PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
('• /a//
LOT BLOCK
OWNER
3. it ,moi L'
ADDRESS p
/..(.,//S its LC�(�.L1
CONTRACTOR
4.
6.
.1 t'
ADDRESS
ul �Y
DESIGNER
ADDRESS
CHANGE OF USE FROM
TO
TYPE
7, OF
WORK
9.
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
• MECH:
DESCRIBEWORK
, �taURA a o4.
VALUATION
❑ RPL.
❑ M.H.
source
of
Utilities
-GAS
PHONE
z.,14-9.4.14/1"
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
PHONE
ZI P
PHONE
ZIP
Required Set Backs in Fee
North (South [East (West
Size of Parcel Zone Classification
Type Const.
Occupancy
Valuation
DWL Area
O MVE.
O POOL
❑ OTHER
Basement Area
Split Entry
No. Baths
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
Storage
No. Rooms
Req'd.
Rancher
Rec. Room
Rec'd.
CTRIC
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
performance of construction.
DATE 1/ — i'—
DEPT.
i
SPECIAL APPROVALS
REQ'D. REC'D.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
//—
DATE
OFFICIAL,( 4,-11 4.,/ t7et,,,t-t,
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
M
DATE /1 --.2 7— 7
04*
E
840, 1 R
11-27-79
zcz 6479.
*7.00
*7.00 (%
*7.006
*000
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11`27 -7t9
840.2
7.002.
CC
F.)
U
W
3-