1979, 10-15 Permit: 79-5977 Wood StoveIPLAN 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. /9 7:2_1 3 oerraS
LOT BLOCK
2.
WNER
3. E S Ca< 0
ADDRESS
97 2247 pco- &
LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISION
PARCEL NUMBER/S
PHONE
92L -G7(2_
ZIP
Required Set Backs in Feet
North 'S• outh
CONTRACTOR
4. siil.T•<2< fe,/f/ntCe✓t??2
P
DDRESS, 37S
PHONE
East (West
Occupancy Sprinklered
Dyes DNo D Req'd.
Size of Parcel Zone Classification
ZIP
Type Const.
5.
DESIGNER
PHONE
Valuation Building Area i Sq. Ft.
ADDRESS
ZIP
DWL Area IBa5ement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE 0 NEW
7, OF
WORK 0 BLD.
TJ ALT. 0 AD N. 0 RPL. D MVE.
❑ PLMB. 0 MECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.44e4 'ar spy S'TW0P
Source
of
9. Utilities
VALUATION
GAS
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 40////7YSIGNATUR/ `-/76 """
`��
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS: •
DATEItf it/79 OF ICIAL
AP
FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
M
PERMIT NUMBER
-79 -%77
DATE
04.*
E
597.6a
10=15-79
2+6479.
*7.00
*7.00 N
*7.006p
*00 8
0
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B COMES,A PERMIT.
1 B. 7:1.51—. 719- 5 9'7,7
if7,0,0Lk