1979, 08-20 Permit: 79-2458 WoodstoveIrLAN NUMBER
APPLICATION/ PERMIT
L
Split Entry
Split Level
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
6.
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
ElAD'N. ElRPL.
LEGAL DESCRIPTION — SEE ATTACHED
No. Baths
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
❑ OTHER
11
I
OWNER
Req'd.
PHONE
Not Req'd.
WORK
POOL
D 'L
3.
02 -
of EXEMPTION
ADDRESS
ZIP
Required Set Backs in Feet
_D --/,. . .
. T� ..
FEES COLLECTED
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Oyes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE 1:1 NEW 11 ALT.
ElAD'N. ElRPL.
❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF
E]BLD. ElPLMB.
IXMECH: EIM.H.
❑ OTHER
11
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
POOL
of EXEMPTION
DESCRIBE WORK
/,I - -
_D --/,. . .
. T� ..
FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. utilities Single $
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 Building
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.
Plumbing
DATE SIGNATURE_ � u�
Mech.
DEPT.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL APPROVALS SPECIAL CONDITIONS:
REQ'D. RECD.
Plan Check
PERMIT NUMBER
DATE
04 *7,00
*7.00
*7.000
E *a00 IS
245.7
08-20-79
;? 6.479,
SEPA
Mobile Home
Other (Specify) -
7
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
Q /��/ THIS BECOMES A )PERMIT. j I' n
DAT 7/ OFFICIAL ) f (� C/i( � 2 Il - / !) (_ t 7. p * /. U U it i-