1979, 12-18 Permit: 79-9242 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
JOB ADDRESS
1. Ss 2 r ESS ivl/�f R0. V /`Prc\A1t
2. jT BLOCK SUWp�I510 D/Twn/ N
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ed��1Qw Z 0G£ ON E
3 1A6r iE t PousSON' 92236.6x_
4.
sDDRESS
, 2A 1?i C Lv/ R. ve/`A'AZ I
CO TRACTOR
'111 gym, +h •
( Rud i- se.
ADDRESS
KresT Remit �y
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
IP
9037
PHONE
ZIP
PHONE
ZIP
TO
AD'N.
0 MECH:
❑ RPL.
O M.H.
❑ MVE.
O POOL
0 OTHER
D SCRIBE WORK
8. o ur_z.Mo ' ex/57— /06' CH/M^oc-Y
VALUATION Source GAS ELECTRIC
of
Utilities
9Weicci U -OAT
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North
South East
Size of Parcel
Type Const.
Occupancy
Valuation
DWL Area
Split Entry
No. Baths
West
Zone Classification
Sprinkiered
Elves ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
Storage
Rancher
No. Rooms
Req'd.
Rec. Room
Rec'd.
Not Req'd.
WATER
SEWER
I hereby cer.,,y 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
!09
SIGNATURE i� (�'7. -ezt L.
SPECIAL APPROVALS
DEPT. REQ'D.
REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE /2// / 9OFFICIAL
•
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
I . L7C7
TOTAL $
PERMIT NUMBER
DATE
04* *7.00
*700 Vii
*7006
E *000 8
924,12
12-18-79
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12-118-79 92425' *7,00 r2