1979, 11-20 Permit: 79-8190 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
C4 OB ADDRESS
�E LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK ISU13DIVISION I PARCEL NUMBER/S
3.'�,t�('
OWNER
orth South
F2 E55
�AD/D
Zone Classification
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
CONTRACTOR
Occupancy
Sprinklered
4'
AD1,4RESS r�
p .(j/4.'T✓LC.
❑Yes ❑No ❑ Req'd.
DESIGNER
5.
DATE J%Zj— 7 SIGNATURE
ADDRESS
Basement Area
CHANGE OF USE FROM
6.
PHONE
ZIP
E
ZIP
PHONE
ZIP
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 WORK ❑ BLD. ❑ PLMB. MECH: ❑ M.H. ❑POOL ❑ OTHER
equired Set Backs in Feet
orth South
East West
ze of Parcel
Zone Classification
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
Type Const.
Occupancy
Sprinklered
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
I
❑Yes ❑No ❑ Req'd.
aluation
Building Area in Sq. Ft.
DATE J%Zj— 7 SIGNATURE
DWL Area
Basement Area
Garage Area
Storage
DEPT. REQ'D. RECD. Plan Check
Split Entry
Split Level
Rancher
Planning
Mobile Home
No. Baths
No. Floors
No. Rooms
Rec. Room
Utilities
TOTAL $—
CERTIFICATE
Req'd.
I Recd.
Not Req'd.
of EXEMPTION
SEPA Checklist� THIS BECOMES A PERMIT.
-.24-/ '�"
PERMIT NUMBER
-7 / gd
DATE
u4* *7.00
*7,00 s
*7,000n6
Cc
81 8,9�
1 1 -20-79
g 6,479,
DESCRIBE WQF3K
8 �( )�% FEES COLLECTED
VALUATION Source GAS EILECTRIC WATER SEWER
of
,r
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 regulating construction r the
performance of construction, Plumbing
DATE J%Zj— 7 SIGNATURE
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $—
Zone Clearance
IN THIS SPACE,
WHEN MACHINE VALIDATED
SEPA Checklist� THIS BECOMES A PERMIT.
-.24-/ '�"
"1 *7.IJ I
DATE ___- __ OFFICIA les#1�fdifA�_�_
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