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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