1979, 10-18 Permit: M79-6287 Woodstove7
PLAN 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
LEGAL DESCRIPTION —.SEE ATTACHED
LOT I BLOCK IbUBDIVISION PARCEL NUMBER/S
vZd'�
OWNER
3. rrNJ��
AD ESS
. �: <)9o-7 c--
CONTRACT9�
4.
ADDRESS
DESIGNER
ADDRESS
CHANGE OF USE FROM ITO
6.
PHONE
�
ZIP__
PHONE
ZIP
PHONE
ZIP
TYPE P NEW ❑ ALT. �OF ❑l AD'N. ❑ RPL. ❑ MVE.
7 WORK ❑ BLD. ❑ PLMB. LJ MECH: ❑ M.H. ❑ POOL ❑ OTHER
CRIBE WORK
8. D W0&1P IvG-T�
Required Set Backs in Feet
Sdurce
North South
East West
Size of Parcel
Zone Classification
Type Co7
Occupancy
Sprinklered
..
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
DWL Area
Basement Area
Garage Area
Storage
1 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
Split Entry
Split Level
Rancher
to give authority to'violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.
Plumbing
No. Baths
No. Floors
No. Rooms
Rec. Room
SPECIAL APPROVALS
SPECIAL CONDITIO S:
DEPT. REQ'D. RECD.
.. _
CERTIFICATE
Req'd.
Rec'd.
Not Rei
of EXEMPTION
Planning
Mobile Home
Other (Specify)
Fire Marshall
FEES COLLECTED
VALUATION
Sdurce
GAS
ELECTRIC
WATER
SEWER
of
..
9,
Utilities
_.
Single $
1 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
Building
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.
Plumbing
O�
DATE G� �y SIGNATURE
MMech. 7-
SPECIAL APPROVALS
SPECIAL CONDITIO S:
DEPT. REQ'D. RECD.
.. _
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Other (Specify)
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
r,
DATEI ' F CIA
AP D FOR ISSUANCE
DATE
TOTAL $
WHEN MACHINE VALIDATED IN TH
THIS,¢IfO I E� A PMIT.
PERMIT NUMBER
M 7-6ae
04* *7.00
*7.00 N
*7.00
E *Q0'0
6286
•10=18=7,9
-4 6.479.
SPACE,
6;-2' 8, 7 Z * 7, 0'.0 �,
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