1979, 11-02 Permit: 79-7220 Wood StoveA LANNI2EIER
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
' LOT L�BOOK SUB 'VISI N
2.
LEGAL DESCRIPTION - SEE ATTACHED
3 owNLatt- ' c'
ADDIRESS (�/^/,-ytiv'_
ONT RgCTQR ��
4.
PHONE--��
i
492 -Ica
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East 'West
PHONE
Size of Parcel 1 Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy Sprinklered
❑Yes ❑No 0 Req'd.
DESIGNER
5.
PHONE
Valuation 1 Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area Basement Area j Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
«NEW 0 ALT. 0AD N. 0 RPL. 0 MVE.
0 BLD. ❑ PLMB. IBJ MECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
DESCRIBE WORK
8. NO010 &WO✓% it
G N/1 frr 2 )
VALUATION S urce I GAS ELECTRIC
of
9. Utl Ilbes
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 . . al law regulating construction or the
performance of construction. n ,� 1
DATE ' Qnr- '77 SIGNATURE GOAL..
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
. Utilities
Zone Clearance
' SEPA Checklist
SPECIAL CONDITIONS: -
DATE !t
111111 O -i
"t FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
I¢1.I,rw
Mech.
Plan Check
SEPA .
Mobile Horne
Other (Specify)
TOTAL $
PERMIT NUMBER
72 - 72z0
DATE
04* *11.00
*1.1.00 th
* 1 1.006
8 *000 B
721.92
1.1 -02-79
3 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
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