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1979, 12-06 Permit: 79-8786 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 — JOB ADDRESS 2� 1. LC / 9d LOT BL CK SUBDI 61ON n Cad - PHONE , / 2. 7 1/ A4%CW4: /.(/ ,I�,IX iY Jci C,Cf-d- PHONE OWNER 3 gyo-C,/.oAti 114,ay DDRESS CC:* //96i/ .ce_ CO[JTRACTOR .Q/b1,a- AD RESS i DESIGNERGNER 4. 5. LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S ZIP 99.261, Required Set Backs in Feet North (South East 'West PHONE Size of Parcel Zone Classification ZIP • Type Const. Occupancy Sprinklered ❑Yes ❑No 0 Req'd. PHONE Valuation Building Area in Sq. Ft. ADDRESS ZIP DWL Area I Basement Area Garage Area Storage CHANGE OF USE FROM 6. TYPENEW ❑ ❑ AL 7. OF WORK BLD. 0PLM B. TO Split Entry Split Level Rancher ❑ AD N. MECH: ❑ RPL. ❑ M.H. ❑ MVE. O POOL 0 OTHER No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Re 'd. Not Req'd. DESCRIBE �WORK 8. v,' K Ott t.'Y.2.(t-d-Lu VALUATION CV] Source GAS ELECTRIC of 9. Utilities 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. SIGNATURE �. I '1 At ♦-.. a ^. WATER SEWER DATE /a2-6 -7 DEPT_ SPECIALAPPROVALS REO'O. RECD. Env. Health Planning Fire Marshall • Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL CONDITIONS: /2-6- 79 DATE OFFICIA 1, 'y APPROVED FOR ISSUANCE FEES COLLECTED Single $ Building Plumbing 7�0 Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL 17' oU . I PERMIT NUMBER 79- ff73% DATE /20-7% *7.0 0 878.5B 12=06'=7i9 f 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 12.'-:0'6°-;7i9' 8/8.6 z A7.0,0 a e