1979, 10-24 Permit: 79-6653 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER 1
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE M'eZ"'3_7/
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 4 * *7,0 0
2,1DB ADDRESS
118./ ,, ,,")_ ), ' .1 ,,ij LEGAL DESCRIPTION - SEE ATTACHED *7.0 0 V)
�
LOT BL K S BDIV ION PARCEL NUMBER/S
665,2
2.
OWNER PHONE 1 0-2 4- / 9
3. ,-;1\s ' ,&7(--et-tA4/:----- ,.-f- :zi-j----y/s7/-
DRESS����/// � ZIP Required Set Backs in Feet
., 1J8t 7 >G1- ?>v171}-4.r. ,.+� AZ "_ 'f�'ftr q47< )-4 North 'South East West
CONTRA OR j PHONE Size of Parcel Zone Classification
tt..J !f ,e
4' •
AyIDRESS �t ZIP Type Const. Occupancy Sprinklered
'1/4%)_.,/2-44,Ge_, ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation 1Building Area in Sq. Ft.
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 ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER -
WORK
El BLD. ❑ PLMB. ❑ MECH: CIM.H. CI POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WO13K
--##--8. t; FEES COLLECTED
VALUATION So ce GAS ELECTRIC WATER SEWER
f
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 .
�,
!L j SIGNATURE�� 2 .. ll:! i ,'.`?,el , // -�'.—'—
DATE fc�" 7 Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
t
SEPA
Planning
—
L
Mobile Home
Fire Marshall .
Co. Engineer Other(Specify)y)
Utilities '/ ,J De,
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist �/� THIS BECOMES A PERMIT.
DATE :2z 7 OFFICIAL ,�.tti�"'�t, 4,L& . '1.0„-'`2 4''7 9 6''6 5,3 2 * 7.0 0 a 12
APPROVED FOR ISSUANCE _