1979, 11-28 Permit: 79-8445 WoodstovePLAN 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
JQB ADDRESS LEGAL DESCRIPTION —SEE ATTACHED
M PERMIT NUMBER
(�
DATE
DFrSCRIBE WORK
�� FEES COLLECTED
8
i ��GCIL
VALUATION Sol ce yGAS ELECT IC WATER SEWER
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 o I al law regulating constru tion or the
performance of construction. 1 + Plumbing
DATE SIGNATURE
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ -D. REC'D. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities �!G'
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist _ -7 j. ,� J ., ( -/�,_ THIS B1ECOMEQS A+7PERMIT.
DATE ', OFFICIA4.1�s1:F .i � �/_Z, C.;.'-''.� _' (t. 1 U !,9. .
LOT
BLOCK[SUBDIVISIONPARCEL
NUMBER/S
2.
OWNER
Ill
PHONE
3.
X
DDRESS
ZIP
Required Set Backs in Feet
-i�
y,
f �
z i
4
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4.
AD1,DRESS
ZIP
Type Const.
Occupancy
Sprinklered
I - 3 �, e-✓
I ❑Yes []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.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE 1-1 NEW
1-1 ALT.
ElAD'N.
1:1 RPL. 1:1MVE.
7,
OF
❑ OTHER
11BLD.
ElPLMB.
X MECH:
ElM.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
M PERMIT NUMBER
(�
DATE
DFrSCRIBE WORK
�� FEES COLLECTED
8
i ��GCIL
VALUATION Sol ce yGAS ELECT IC WATER SEWER
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 o I al law regulating constru tion or the
performance of construction. 1 + Plumbing
DATE SIGNATURE
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ -D. REC'D. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities �!G'
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist _ -7 j. ,� J ., ( -/�,_ THIS B1ECOMEQS A+7PERMIT.
DATE ', OFFICIA4.1�s1:F .i � �/_Z, C.;.'-''.� _' (t. 1 U !,9. .