1979, 12-05 Permit: 79-8741 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED
SPACES - F�Ra—`�'�ARD TO MAKE 4 COPIES
JOB ADDRESS
�. F. 7S) C.5
LOT BLOCK
5UBDt VISION
2.
O NER �/� pp y-
3 .0..rit GI- *Let A A to
ADDRESS I
(, 7c5iS 7f1.af-I. eit., 2 UktofL
CONTRACTOpR n
IHn4r tarieLttr.Cct- P.fc
%7 ADDRESS
Q i .LLTO.ed AL A-ru _,.. 4ce
DESIGNER
5.
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
PHONE
47%,
ZI P
99 b
Required Set Backs in Feet
North 'South
East (West
PHONE
C/ A( -4/A-11.
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Oyes ONo 0 Req'd.
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
OWL Area I Basement Area r Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
O NEW
❑ BLD.
O ALT.
❑ PLMB.
O AD N. O RPL. 0 MVE.
MECH: 0 M.H. 0 POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE -
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE
8. ,WORK _O474ijA$61U
4(/YiLl
VALUATION Puree GAS ^CTRIC
of
9. Utilities
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 or local law regulating construction or the
performance of construction.
DATE/CZ—S.— 79 SIGNATUR
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
--fit 79 ////�,s �.1 �
DATE OFFICIA211•fZ.�1�41
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 7
DU
M
PERMIT NUMBER
DATE la-- .79
04*
*7.00
*7.00
87402
12-05-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
121+, 0.5'',,71'9'
8741=
OAR a