1979, 11-15 Permit: 79-7935 WoodstovePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
-72,15-
DATE Z 15-- 7
I,EJ� n
*7.00
E
793.4
11-1-79
647
_ 9,
DE CRIBE WO
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
S
OBJOB ADDRESS
VALUATION urce GAS E CTRIC WATER SEW]this
LEGAL DESCRIPTION — SEE ATTACHED
Single $
LOT
BLOCK
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances goverBuilding
PARCEL NUMBER/S
2.
to give authority to violate or cancel the provisions of any other state or cal aw r ul n constructioPlumbingperformance
ISUBDIVISION
�
DATE —� SIGNATURES
40
O NE
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
PHONE
DEPT. REQ'D. RECD.
3.
Env. Health
~4
Planning
A DRESS
Mobile Home
Co. Engineer
ZIP
Required Set Backs in Feet
�Q
TOTAL
'� i
i?j"5 7
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist !/
THIS BECOMES A PERMIT.
l
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`7
North South East West
r.
C TRACTOR
PHONE
Size of Parcel
Zone Classification
4'
ADPRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE NEW
❑ALT.
1:1AD'N. ❑ RPL. 1-1MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
1:1 OTHER
El BLD.
1-1PLMB.
AMECH: ElM.H. ElPOOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
PERMIT NUMBER
-72,15-
DATE Z 15-- 7
I,EJ� n
*7.00
E
793.4
11-1-79
647
_ 9,
DE CRIBE WO
8
FEES COLLECTED
VALUATION urce GAS E CTRIC WATER SEW]this
ofF
9. Utilities
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances goverBuilding
type of work will be complied with whether specified herein or not. The gr ing of a per i e of
to give authority to violate or cancel the provisions of any other state or cal aw r ul n constructioPlumbingperformance
of construction.I'
�
DATE —� SIGNATURES
40
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
Utilities
TOTAL
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist !/
THIS BECOMES A PERMIT.
l
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I_ � ! j � /5 ` ! 1 c� * 7 U Cl
DATE 0FFICIA1 2"//'.J/J1 t�i/♦%/ ..
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