1979, 10-19 Permit: 79-6393 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT M 79—0393
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675DATE /D—/ '7'i' '
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 4 * *7.0 0
JOB1. e ADDRESS_ �•
LEGAL DESCRIPTION — SEE ATTACHED *7.0 0 n
LOT BLOCK SUBDIVISION '/ PARCEL NUMBER/S 6 3 9.2 2
2.
07ER PHONE 1 0— 1 9-79
3. � , —U 1/‘; 4 7 9.
A'�9`DRESS _ ZIP Required Set Backs in Feet
p. gc..nr r,C7,5 h„_, 7 � ry.r�--; ^, P'!L �'y-.,,.,.0 lam, North ISouth East 'West
CONTRACTOR PHONE Size of Parcel Zone Classification
4• p ZIP Type Const. Occupancy Sprinklered
,% ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area I Basement Area Garage Area I Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. CI AD'N. CI RPL. ❑ MVE.
7, OF ❑ OTHER
WORK CIBLD. ❑ PLMB. 4. MECH: CIM.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WO —f �t
8. I V L Cog.. -t FEES COLLECTED
VALUATION S urce GASB I EL TRIC 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 regulating construction or the
performance of construction. Plumbing
• c9
DATE j�IJ'—f42,7�i� 74.
SIGNATURE y /, fie// .A /-z'4,' 7_�
Mech. i c�
SPECIAL APPROVALS SPECIAL C9I4DITIDNS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
cc
SEPA CD
0
Planning — U
w
a
Mobile Home rn
Fire Marshall z
Co. Engineer Other (Specify)
Utilities 'C)
TOTAL $ 7,_
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist � THIS BECOMES A PERMIT.
DATW"1/9 7 OFFICIAL1 0- 191-7'9 6'3 9'3 Z *Z O.O,a p'
APPROVED FOR ISSUANCE —