1979, 10-30 Permit: 79-6974 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
1.
JOB ADDRESS
(o UO / 11011,1)1D'il `Y
LOT BLOCK SUBDIVISI
2.
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
3.
4.
5.
D of ►t1 FLA
ADDREfV/�SS&�7 MO hi 4/1 eier
CONTRACTOR C I
P ONE
3787
1531- (IDI
9zo�
Required Set Backs in Feet
North 'South East 'West
PHONE
Size of Parcel - •l Zone Classification
ADDRESS
DESIGNER
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd. •
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
IE NEW 0 ALT. 0„, �AAD N. 0 RPL. 0 MVE.
❑ BLD. 0 PLMB. IfPMECH: - ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE -
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
9.
9.
DESC RIB�E!/�K sTO V V (III I -c
VALUATION
Source
of
Utilities
G S
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 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 lS2---C-7-567/ /7C 7f- SIGNATURE
'DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DAT E42 FPI
APPR ! "1R ISSUANCE
- FEES COLLECTED
Single $
Building
Plumbing
Mech. 7, OO
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
72 -071-
DATE
04* *7.00
*700 En •
*7,008
B *aoo 8
697.3E
10—'30-79
B 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10k130'"179 697.42 *7.0:0°.�