1979, 10-10 Permit: 79-5471 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT ��M r7
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRE HASID TO MAKE 4 COPIES 0 4* * 7.0 0
JOB ADDRESS * 7.O 0 V~j
1. It?-4v �, -/i y LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S 2 002-- *7,0 0 U
2. E * 000 8
3. Ow�OLII/ 1r 1'V,4L 1 4JLL9jll 4,..28E__56.0....
547,0
ADDRFL�S�S/)t� c/`/ ZIP Required Set Backs in Feet O (�
1 . 1 `�0 V` 1 Y I 9� North 'South East (West 1 0 4-0 8_7 9
CONTRACTOR PHONE Size of Parcel Zone Classification L 4�f n
4' ADDRESS ZIP Type Const. Occupancy Sprinklered U / 7
❑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 RINEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ,—,/ CIOTHER
WORK
El BLD. ❑ PLMB. Ifd MECH: ❑ M.H. El POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DES RIBE WORK
FEES COLLECTED
8. WO I�JF4I\� iV
VALUATION Source GAS ELECTRIC 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 stat or local law regulating construction or the
performance of construction. ��j Plumbing
DATE /0— W.-75 SIGNATU _�(��rll' / & 2 (Mech. 4 l 7
, °
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA �
Planningc.
— w
0
Mobile Home C/D
Fire Marshall z
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
_ WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist j(_�/ r THIS BECOMES APE�RMIT.
DATE y/ --)c)) O F F I C — J 1 0-1 '7/ 7 MEP * 7.O 0 2
APPRO k FOR ISSUANCE _