1979, 11-05 Permit: 79-7291 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
M
PERMIT NUMBER
_1b7cl-72gI
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1
LOT
2.
BL
r rR
OWNER ,_p
\2 C".L EV-ELf A -0
ADDRESS
PHONE
4 y
ZIP py Required Set Backs in Feet
CI I Z_OG North 'South East 'Wes
low
04'* *7.00
LEGAL DESCRIPTION - SEE ATTACHED *7. 0 0 N
729.0B
11-05=79
6479.
PARCEL NUMBER/S
4.
CONTRA
PHONE
Size of Parcel - Zone Classification
ADDRESS
ZIP Type Const.
Occupancy Sprinklered
Eves CNo 0 Req'd.
DESIGNER
5. ADDRESS
PHONE Valuation
Building Area in Sq. Ft.
ZIP DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE 0 NEW
7. OF
WORK 0 BLD.
0ALT. 0 AD N. 0 RPL. 0 MVE.
0 PLMB. 'MECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors No. Room
Rec. Room
CERTIFICATE - Reg'd
of EXEMPTION
Rec'd
Not Req'd
8.
DESCRIBE WORK
V1/4.)07:731") As. A rIAS-co
VALUATION Source GAS ELECTRIC
of
9. Utilities
WATER
SEWER
I hereby certify that I have read and examined this applica ion 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 r-. ting con truction or the
performaaaiy e of construction. /
DATE Wei S- a SIGNATURE,' ".L
/._,
Al'
SPECIAL APPROVALS SPECIA ONDI •NS:
DEPT. REQ'D. REC'D.
FEES COLLECTED
Single
Building
Plumbing
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
Plan Check
SEPA
Mobile Home
`dab
ARrvnt.tt- C97i
5tfie, ISPeCIfV1
TOTAL
$t7. Oa
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT. 7 2191
1'1'- 0 7'9'
DATE OFFICIAL
*7.00x1 -
APPROVED FOR ISSUANCE -
K
O
r—
U
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y