1979, 11-19 Permit: 79-8133 Wood StovePLAN NUMBER
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
JOB ADDRESS
1. 7/' 5/2/
2.
3
LEGAL DESGRIP.TtON — SEE ATTACHED
PARCEL NUMBER/S
O NER
,i�. 11t4t C9J4J4 f
PHONE
9.-, - 7.. ,
• ADDRESSJ 74(Q� i ccr� ,AP. -4441,5a
CC TRACTOR
4.
AD RnESS -
SF/ 1Wr'YW
DESIGNER
5.
ZIP
Required Set Backs in Feet
North 'South East 'West
PHONE -
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Oyes ONo O Req'rl.
PHONE
Valuation 1 Building Area in Sq. Ft.
ADDRESS
ZI P
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE 0 NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
7. oF 0 OTHER
WORK 0 BLD. 0 PLMB. ig..MECH: 0 M.H. 0 POOL
0 SCRIBE WORKenyz7 ,yq / .'�',�^/yam �,�✓_r/q'_r p
t2IInitul-x) /�i./.iW/—I'Ti� ir-L '4 £CTRICfl/l-e—
TION ! Source GAS EL
of -
Utilities
8
9.
No. Baths
No. Floors
No. Rooms
Rec. Room
• • CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
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. a44-44-"--
DATE P-/-7-79
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
// -19 797 .i,,a _.c
DATE OFFICIA �
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
/7;
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL 171-a
/4
DATE //_i 7'-79
PERMIT NUMBER
04* *.7.30
*7.00 15
*7.0016
E *Q0.0
8132e
1'1-19'=79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'1'1'=-497''719' 8'13:3 z ''7.0 0•a'IJ-
CC
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