1979, 09-24 Permit: 79-4613 Wood StovePLAN NUMBER
APPLICATION/PERMIT
.SPOKANE COUNTY — BUILDING CODES DEPARTMENT.
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HAROTO MAKE 4 COPIES
1.
2.
3
4.
JOB ADDR/ESSS/0
orb-1Liszcfl
LOT BC. CK
SU SUBDIVISION
n
LEGAL DESCRIPTION - SEE ATTACHED
OWNbcER
L� M`r7(14Ca.
ADDRESS
NO- LeNr414
.CONTRACTO
C2AM
ADDRESS
PHONE '
229- zoq-8
921
PHONE.
PARCEL NUMBER/S
Required Set Backs in Feet
North (South East (West
Size of Parcel Zone Classification
ZIP
Type Const.
Occupancy Sprinklered
Oyes ONo O Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. FL
ADDRESS
ZIP
OWL Area !Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
fla NEW 0 ALT. 0 AO N. 0 RPL. 0 MVE.
0 BLD. O PLMB. IUrMECH: O M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE yy,QyK
8.
VALUATION
9.
Sou a GAS
of
Utilities
ELECTRIC
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 correc . 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.C
DATE 7-c) / - / SIGNATURE
DEPT.
SPECIAL APPROVALS
REG'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE2/X/ /tOFFICI
APPRO` EU FOR (SSU
NCE
FEES COLLECTED
Single $
Building
PERMIT NUMBER
Nj r _ g -(o 13
DATE
Plumbing
+7, coo. -
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
04* '*7.00
*7.00 15
461.21
09-24-79
3 6479:
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BCOMES APERMIT.
0 9'-:Q2'4!-;71 4'613 z
*7.0'O;ag
CC
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d
CO