1979, 11-06 Permit: 79-7335 WoodstovePLAN 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
B ADDRESS
LOT BLOCK
2.
LEGAL DESCRIPTION — SEE ATTACHED
SUBDI ISION
PARCEL NUMBER/S
OW R
i
3. i n -L / t.,l.IL,C.t C..p /
AD RESS l ,
-r ; �.'lo_, .,,lc1,.. Q._
CONTRACTOR
4' ADDRESS
' a1 L
PHONE
- Lt—�, �'
ZIP
PHONE
Required Set Backs in Feet
North (South 1East (West
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation (Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7, OF
WORK
❑ NEW
O 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.
Rec'd.
Not Req'd.
D SCRIBE WORK
VALUATION
9.
Sgurce
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 /1—c51" 7 `J
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE OFFICIAL1'L Li'
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ 7
PERMIT NUMBER
DATE / �' r
04* *7.00
*7.00
*7,00U
E *0,00
73342
11-06-79
2 6479.
{
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11L_06_79
7)1.5c` *7.00
INSPF( (1R