1979, 09-21 Permit: 79-4483 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS.F{ARD TO MAKE 4 COPIES
JOB ADDRESS
6
LOT l BLOCK $UD ISION
z. J I % �� / i r�10 r d ex I dhA.)
3. O E//�� %f
4t.t [X� ( . , 41
ADDRESS
CONTRACTOR
4.!A zt&li�
AD RESS
/! ,,*LL -
PHONE
9%i-(;/ i
LEGAL DESCRIPTION.— SEE ATTACHED
PARCEL NUMBER'S 75-�"h, — /Wolc. -
tor .- ,ex -K
N/L C ,//Etcl ES2-,4rEs
South East 'West
21P
Requlreel Set Backs in Feet.
North
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Dyes DNo D Req'd
DESIGNER
PHONE
Valuation
Building Area In Sq. F
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
J, OF
WORK
D NEW
❑ BLD.
D ALT.
❑ PLMB.
D AD N.
❑ MECH
❑ RPL.
❑ M.H.
❑ MVE.
D POOL
0 OTHER
No. Baths
No. Floors
No. Room
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Reed.
of Req'd.
DESC IBE WORK
8. `.ca.2
VALUATION
9.
Sourde
of
Utilities
/44--e-d_att GAS ELECTRIC / R/ tWATER
e
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 grant • r of a permit does not presume
to give authority to violate or cancel the provisions of any other state or loc. law regul.ting onstruction or the
performance of construction.
DATE q'— .Z/ —"
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL' • DITIONS:
[j
DATE-7 IFOFF IA4/7 /
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
60
60
TOTAL $ 7�.
M
PERMIT NUMBER
79-1/18-3
DATE q --Z/ '79
Oa.*
*7.00
*7.00 lb -
448.21 44&21
09-21-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS COME APE MIT.
�5i :Q' i;.7, 4.48,32
*7,00,°4-1