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1980, 03-24 Permit: 80-2579 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. 4. JOB ADDRESS LOT BLOC //a 3 77. K SUBDIVISION LEGAL DESCRIPTION - SEE ATTACHED OWNER ADDRESS CONTRACTOR PHONE 9a�-9a3s� PARCEL NUMBER/S ZIP 99,2a‘, PHONE ADDRESS ZIP 5. DESIGNER PHONE ADDRESS ZIP Required Set Backs in Feet North 'South East (West Size of Parcel - Zone Classification Type Const. Occupancy Sprinklered ❑Ves DNo 0 Req'd. Valuation Building Area In Sq. Ft. DWL Area I Basement Area ( Garage Area Storage CHANGE OF USE FROM 6. TO Spilt Entry Split Level Rancher TYPE 0 NEW 7. OF WORK 0 BLD. ❑ ALT. ❑ PLMB. ❑ AD N. ❑ MECH: ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL 0 OTHER No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Recd. Not Req'd. DESCRIBE WORK 8. /2 VALUATION B. Source of Utilities 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 - SIGNATURE DEPT. SPECIAL APPROVALS REQ'D. REC'D. Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL CONDITIONS: DATE 3 -au OFFICIAL` i \I�.JVLvVUC�Y� APPROVED FOR ISSUANCE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ �� PERMIT NUMBER M-cao-asriq DATE . J7 a/ /sgo 04* *7.00 *7.00 *7.008 E *000 257.88 03-24-80 2 6479. - WHEN MACHINE VALIDATED IN THIS SPACE, THIS O'5.r-21 EzS'A ,E,jiMIT. 2 Cil 9 Z