1979, 10-02 Permit: 79-5125 WoodstovePLAN NUMBER - APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARr,TO MAKE 4 COPIES
JOB ADDRESS
S- 5- r-, S HA LEGAL DESCRIPTION -SEE ATTACHED
1. LOT BLOC!
2.
OWNER
3. X1,41.-- L
ADDRESS
E7 -
CONTRACTOR
4 SAME
ADDRESS
DESIGNER
5. ADDRESS
SUBDIVISI N I PARCEL NUMBER/S
CHANGE OF USE FROM
6.
PHONE f
ZIP
Required Set Backs in Feet
North South
PHONE
Size of Parcel
ZIP
Type Const.
Occupancy
PHONE
Valuation
ZIP
DWL Area
Basement Area
Split Entry
Spli+.
No. Baths
No. Floors
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area Storage
_eve) I Rancher
No. Rooms Rec. Room
I YFL ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF__,�� 11OTHER
WORK El BLD. El PLMB. e MECH: ❑ M.H. POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. Lunt)o INC?a/ I ATinA/ FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
!a 0 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 regulating construction or the
performance of construction.
Plumbing
DATE' ^ 29 _ SIGNATURE0.��2��G� 'e Z�
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
Plan Check
SEPA
Mobile Home
Other (Specify)
—7 00
TOTAL $, /��
PERMIT NUMBER
M 79-51zs
DATE oe—T 177`1
04 * *7.00
*7.00
*7.010c
B jrv�u
51 2.4�
10-02-79
2 6.479,
WHEN MACHINE VALIDATED IN THIS SPACL,
THIS BECOMES A PERMIT.
1 0 -0 2 ? 2,;'