1979, 09-28 Permit: 79-4909 WoodstovePLAN NUMBER APPLICATION/ PERMIT
PERMIT NUMBER
�,t'
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
I
DATE ,/_ 7
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO �IMAKE 4 COPIES
0 4 * * 7. 0 0
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
* 7.0 0
1 `_ ,� 4�,
4 9 0 8;2
LOT
BLOCK SU DIVISION,
PARCEL NUMBER/S
2
o9-28-79
OWNER ' n
PHONE
3.
6479.
ADD ESS
ZIP
Required Set Backs in Feet
, i*,-) ��51'/ 1 �d�/�- � j, �
`i L% �3 ��
North South East West
CONT ACTOR
PHONE
Size of Parcel
Zone Classification
4' ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
J
❑Yes ❑No El 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.
TYPE 1:1 NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
], OF El❑OTHER
BLD. ❑ PLMB.' MECH: ❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
/ i I FEES COLLECTED
8. i
y a utG�4 c c a� ",
VALUATION
SourceGAS
ELECTRIC
WATER
SEWER
9.
of
utilities
o
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 7 - ,�/ g— �Z SIGNATURE � '`
-7. Mech. L
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
_ I
Fire Marshall Mobile Home
t
t
Co. Engineer Other (Specify)
Utilities %1
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist i THIS BECOMES A PERMIT.
"--�- �'7 lY1 LL..: l �� �;
I
DATF; fY . A .�..
OFFI CIAI 1/L�.� �t�,i.i'%i