1979, 10-23 Permit: 79-6524 Wood StovePLAN NUMBER
�►PPLICN/PERMIT
PERMIT
PERMIT NUMBER
„R�
SPOKANE COUNTY -;BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS.HARD TO MAKE 4 COPIES
0 4 *
* 7.0 0
n
t5 47.00
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
1. O
* 7 0 0,6
LOT
1. BLUCK
SUBDIVISION
PARCEL NUMBER/S
2.
-
E
I�
* V1 O O V
OWNER �� � ��
PHONE � J
3.
652321
ADD��R7I SS tt II �i�
p
Required Set Backs in Feet
.?.o ca
North South East west
1
0— 23 79
CONTRACT RPHONE
Size of Parcel
Zone Classification
R
6479
4' ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes [:]No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
��,�
TYPE L7'NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF / ❑OTHER
❑ BLD. ElPLMB. MECH: ElM.H. 1-1POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRJ BE WORK
i FEES COLLECTED
8 I `✓ v
VALUATION Source
GAS
ELECTRIC
WATER
SEWER
. of
9. Utilities
Single $
_
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 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.
p Plumbing
'
DATE � — / SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
o
Planning
_
Uw
Mobile Home
Fire Marshall
cn
z
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist THIS BECOMES A;PERMIT.
% 11 'O t-ce.'2 I ly 1;7'9-
6`I'5' •2, 4 z
DATE /� Fg,_
APPSUANCE
-