1979, 12-13 Permit: 79-9064 WoodstovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE /�—"-11 '%
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
PERMIT NUMBER
79-- qoP
JOB ADDRESS �j�
1. (i J1/'
LOT BLOCK SU V SION
2.
,R0/1/
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
3.
ADDRESS
PHONE
ZIP
Required Set Backs in Feet
North 'South 1East 'West
CONTRACTOR
��DyyR^^ES�S S''
DESIGNER
5. ADDRESS
PHONE
ZIP
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation 1Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
J�1 MECH:
❑ RPL.
O M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
SCRIBE WORK
8. �� p r�t�sY✓✓
VALUATION
9.
Source
of
Utilities
frit/ Li---At'At&i
GAS ELE RIC WATER
SEWER
1 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
of work will be complied with whether specified herein or not. The granting of a permit does not presume
tu give authority to violate or cancel the provisions of any other sJa-t r\local law regulating construction or the
performance of construction. f P
DATE /. / -7
SIGNATUR\ t; C -e
DEPT.
SPECIAL APPROVALS
REQ'D.
REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE OFFICIAI ft/JAIL
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ e// e
C * * i 1.00
* 1 1, t 0
* 11,00
E *OO..
90632
12-13-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12' '13-7° :6.4 *11.I