1979, 12-28 Permit: 79-9572 WoodstovePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESC IB WORK
s. �o�r�
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
JOB AODRE�
O
1,0
VALUATION
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
LEGA4 DESCRIPTION - SEE ATTACHED
GAS
LOT
BLOCK
SUBDIVISION
DATE/ / SIGNAT
�y 1
w
PARCEL NUMBER/S
2.
SPECIAL APPROVALS
I
9.
Utilities
Env. Health
OWNER
� •
G�
SEPA
Planning
PHONE
�� ' 3�
3.
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
ADD
E55 �
��
��� �
IP O /�
�l�
Required Set Backs in Feet
l/J�
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4'
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
J.
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE NEW
❑ ALT.
ElAD'N. 1:1RPL.
❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
],
OF
El BLD.
❑ PLMB.
�/
52 MEC H: ❑ M. H.
❑ OTHER
❑ POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
of EXEMPTION
I
DESC IB WORK
s. �o�r�
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
VALUATION
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Source
GAS
ELECTRIC
WATER
SEWER
DATE/ / SIGNAT
�y 1
w
of
Mech.
SPECIAL APPROVALS
SPEqW CONDITIONS:
9.
Utilities
Env. Health
FEES COLLECTED
Utilities
Zone Clearance
SEPA Checklist
PERMIT NUMBER
M1/ r
DATE
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
//
THISIB COI A PElRMIT.
DATE �� OFF L. ')_�'d� �
r—
c
_ w
e�_
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.
Plumbing
DATE/ / SIGNAT
�y 1
w
Mech.
SPECIAL APPROVALS
SPEqW CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
PERMIT NUMBER
M1/ r
DATE
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
//
THISIB COI A PElRMIT.
DATE �� OFF L. ')_�'d� �
r—
c
_ w
e�_