1979, 10-23 Pemrit: 79-6532 Wood StovePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WO
8 �� ¢ �—j—�
l•
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
S rce'
GAS
LEGAL DESCRIPTION — SEE ATTACHED
WATER
SEWER
9.
LOT
BLOCK
SUBDIVISION
I
PARCEL NUMBER/S
2.
I
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
Building
O ER
^
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
PHONE
Plumbing
3.
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D.
Plan Check
ADDRESS
SEPA
ZI�Py
Required Set Backs in Feet
! ��
Mobile Home
���-
Other (Specify)
% �
North South
East West
CO TRACTOR
Zone Clearance
PHONE
Size of Parcel
Zone Classification
4. -441 C.
L "L l
A DRESS
ZIP
Type ConsT7J
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE ❑ NEW
E) ALT.
1:3AD'N. 1:1 RPL.
1:1MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF
❑ OTHER
WORK ❑ BLD.
❑ PLMB.
XMECH: ElM.H.
❑ POOL
CERTIFICATE
Req'd. I
Recd.
Not Req'd.
of EXEMPTION
DESCRIBE WO
8 �� ¢ �—j—�
l•
FEES COLLECTED
VALUATION
S rce'
GAS
ELECT IC
WATER
SEWER
9.
of
Utilities
Single $
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
Building
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.
— d� G
Plumbing
DATE /� , 7 7 SIGNATURE��je, v��C. �
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D.
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
Utilitiese
TOTAL $
Zone Clearance
WHEN MACHINE VALIDAI
SEPA Checklist /(//� /)
THIS BECOMES A PERMIT.
II-7
IJ
L "L l
PERMIT NUMBER
M 7
DATE %G —, 3'— -72
04* *7.00
*7,00
TH
653, 1
10-23-79
-g 6479,