1979, 11-20 Permit: 79-8192 Wood Stove PLAN NUMBER APPLICATION/PERMIT
PERMIT NUMBER I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 75)` $1 f
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
DATE if/1"` --/IF
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS 0 4 * * 7,0 0
LEGAL DESCRIPTION - SEE ATTACHED
1OT/ BLK SU�DI ISV I"ON ��� 19� PARCEL NUMBER/S * 7'O Orn-
2. 819: 18
op . PHONE
3. 7/1 :1 q. - 25 1 1 -20-79
AS�y , ZIP Required Set Backs in Feet
Al 19 1 tl �I,�y(' j. ,tio•4�AW�`e_ 47 7lY North South East West 7 9,
CO TRACTOR PHONE Size of Parcel Zone Classification
ADD ESS ZIP Type Const. Occupancy Sprinklered
.44 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER Req'd. Recd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. MECH: I=I M.H. El POOL CERTIFICATE
of EXEMPTION
SCRIBE WORK
8. .0.0e ,�{J{_$ . J(�Dw �./� FEES COLLECTED
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 state or local law regulating construction or the
performance of construction.
Plumbing
DATE it—c:2--42—
""01.-42-. 7 g SIGNATURE Mech. ` /�— O
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
cc
SEPA o
Planning U
— w
a.
Fire Marshall Mobile Home z
Co. Engineer Other (Specify)
Utilities i✓J
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
),y`a7 79 ���
DATE OFFICIA i�L. 1 1 —2 0 L_ '9 3 1 9. 2 5 k 7,0 0 ° I-
APPROVED FOR ISSUANCE _