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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 _