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1979, 10-11 Permit: 79-5777 Wood StovePLA" NDMBER APPLICATION/ PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT e NORTH 811 JEFFERSON /SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES JOB ADDRESS 2�a.s�Ul LEGAL DESCRIPTION — SEE ATTACHED ' S LOT BLOCK SUBDIVISION 77PARCEL NUMBER/S 2. MON R 3.5 ADDRESS CONTRACTOR 4. ADDRESS DESIGNER 5. ADDRESS (% CHANGE OF USE FROM TO 6. PHONE ZIP PHONE ZIP PHONE ZIP — LJ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7, OF El OTHER WORK ❑ BLD. ❑ PLMB.MECH: ElM.H. El POOL Required Set Backs in Feet North South East West Size of Parcel Zone Classification Type Const. Occupancy Sprinklered ❑Yes []No ❑ Req'd. Valuation Building Area in Sq. Ft. DWL Area Basement Area Garage Area Storage Split Entry Split Level Rancher No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. I Rec'd. Not Rec PERMIT NUMBER _ S -7 DATE UtJCKlbt WORK $, C C :5 FEES COLLECTED VALUATION Source GAS ELECTRIC WATER SEWEJR 9. Utilities � Y— �- Single $ 1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions i on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governBuilding type of work will be complied with whether specified herein or not. The granting of a permit does not p to give authority to violate or cancel the provisions of any other state o cal law regulating construction performance of construction. Plumbing DATE — IZd — //— 7 / SIGNATURE Mech. SPECIAL APPROVALS SPECIA NDITIONS: DEPT. REQ'D. RECD. Plan Check Env. Health SEPA Planning Fire Marshall Mobile Home I\ Co. Engineer f Other (Specify) Utilities `� TOTAL $ /� ©O Zone Clearance WHEN MACHINE VALIDATED C IN SEPA Checklist CO S A MIT. THIS B F pF_R �11 ,—I�Ip —, D 111 14 { S � 7 f71 DATE OFFI L APP FOR ISSUANCE u4* *7. *7 7 77.6=2 10-11-79 z 6.479. 5'77:72 *7,0000