1979, 11-09 Permit: 79-7590 Wood StovetISI
PLAN NUMBER
1-
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
1
JOB ADDRESS
aw
LO BLOCK
2.
6'
LEGAL DESCRIPTION - SEE ATTACHED
SUBD tISION
PARCEL NUMBER'S
owJVER (p/ p /1 •
3 .,A iti.e442J �L Watt
DRESS
.1/4114-60— (it Ariz .ce
CONTRACTOR
Sa� GZ,nQ2--
ADDRESS
DESIGNER
4.
5.
PHONE �t
ZIP
Required Set Backs in Feet
North 'South
East
'West
'PHONE
Size of Parcel
Zone Classification -
ZIP
Type Const.
Occupancy
PHONE
Valuation
Sprinklered
❑Yes DNo 0 Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area
Garage Area
• Storage
CHANGE OF USE FROM
TO
'Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
O PLMB.
O AD N.
Aj MECH:
❑ RPL.
0 M.H.
O MVE.
O POOL
-❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
- CERTIFICATE
of EXEMPTION
Req'd..
Recd.
Not Req'd.
D/6,SCRI__BE WORK Q "� D �)
8. WY( -O .G . s -sl, �'iI.cLst x .(A.4 --/:/LLfi:ft.
VALUATION Source GAS EL CTRIC
of
9.
Utilities
WATER
SEWER
I hereby, certify that I have read and examined this applica ion and have read the "NOTICE" pro
on reverse side, and know the same to -be true and correct. All provisions of laws and ordinan
type of work will be complied with whether specified herein or not. The granting of a permi do
to give authority to violate or cancel the provisions of any other state or Io . aw regulatin c
performance of construction.
DATE / /'—'7 79 SIGNATURE
visions included
s governing this
Pys not presume
truction-or the
SPECIAL APPROVALS
DEPT. REQ'D.
REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
//---"1-79
DATE / OFFICIALOFFICIALZ2-4400Sa46✓"—
APPROVED FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
PERMIT NUMBER
7,:argd
DATE //— 7q
Other (Specify)
TOTAL
v0
04* *7.00
*7.00 t5
*7006
E. *000
758.92 .
11-09-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1i1 -09'7,1.79i
•
75t9.0z *7,00?.