1979, 12-11 Permit: 79-8943 WoodstovePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBERA 1 7,? ..�
v
DATE Z—Z-11— M
C tt i
-A f u
y u
E h
89412
12-11-79
6&79,
DESCRIBE WORK
$ � FEES COLLECTED
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
LEGAL DESCRIPTION — SEE ATTACHED
14r
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
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DATE / --� d"" ! SIGNATURE `-' tv Mech.
BLOCK
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
PARCEL NUMBER/S
2.
I
ISUBDIVISION
Planning
_
Fire Marshall Mobile Home
NE a
Utilities
PHONE
3.
/
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
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ADDRESS
ZIP
Required Set Backs in Feet
North South East West
CO TRACTOR
PHONE
Size of Parcel
Zone Classification
4'
—[--
AD RESS
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
6.
No. Baths
No.
Floors
No. Rooms
Rec. Room
TYPE 1:1 NEW
El ALT.
EJAD'N. 11 RPL.
ElMVE.
7,
OF
❑ OTHER
❑ BLD.
❑ PLMB.
K MECH: ❑ M.H.
❑ POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
of EXEMPTION
I
PERMIT NUMBERA 1 7,? ..�
v
DATE Z—Z-11— M
C tt i
-A f u
y u
E h
89412
12-11-79
6&79,
DESCRIBE WORK
$ � FEES COLLECTED
VALUATION itource GAS 9LECTRIC WATER SEWER
of
9. — Utilities Single $
I hereby certify that 1 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
Plumbing
performance of construction.
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DATE / --� d"" ! SIGNATURE `-' tv 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.