1979, 11-05 Permit: 79-7295 WoodstovePLAN NUMBER
APPLICATION/ PERMIT
PERMIT NUMBER —I
M 7-7Z 5 -
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE 11751-79
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
04* * 7, 0 0
* 7.0 0
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
1. 1
* 7. 0 06S
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2
E * 0. 0 0 S
OWNER
PHONE
3.
- 20
729,42
ADDRESS
ZIP
Required Set Backs in Feet
o/
0
11-05-79
q-51 1 L
North South East West
6479,
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4. ADDRESS
ZIP
Type Const,
Occupancy
Sprinklered
[]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
s.
TYPEZ?f�EW ❑ ALT. ❑ AD'N. El RPL. 11 MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF
❑ OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
❑ BLD. ❑ PLMB. 60iMECH: ❑ M. H. ❑ POOL
WORK
of EXEMPTION
I
DESCRIBE WORK
8 lA 0
FEES COLLECTED
VALUATION Source
GAS ELECTRIC WATER SEWER
��, of
9. Utilities
Single $
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 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 regu ating construction or the
performance of construction.
Plumbing
DATE / 7F
�r
SIGNATURE— " V
Mech.ff fr—
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D.
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DATE //�'� 0 F F I C I AA
Mobile Home
Other (Specify)
b
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
7 f' _) '
*rf,n 1 F