1979, 10-22 Permit: M79-6464 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
No. I i 0 G etAL-VitNI
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
OWNER -,_ /✓''tea F.-1t\I
ADDR
4.
1IO 7 c L'/IN
CONTRA TOROR
l
ADDRESS
PHON
2 &�i
ZIP
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East 'West
PHONE
Size of Parcel
Zone Classification
ZI P
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5' ADDRESS
ZI P
DWL Area I Basement Area
Garage Area I Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths No. Floors
CERTIFICATE Req'd.
of EXEMPTION
No. Rooms
Rec. Room
Rec'd.
Not Req'd.
8.
9.
DESCIRIBE WORK
C7C,I;7 i1-NNIN,
VALUATION
Source
of
Utilities
G S
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
performance of construction.
DATE l'() 12l/ 1
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
r
,V F F I C
APP; ! ! OR SSUAI CE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
DATE
1
PERMIT NUMBER
04* *7.00
*7.00 ro
*7,0064
E *0.00
64632
10-22-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B COMES p. P MIT.
10-22-19 6'46.42
*7,0.0,2F-'
I ni0DCPTno
CALvHJ