1979, 12-10 Permit: 79-8883 WoodstovePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK
8.0
VALUATION Source GAS ELECTRIC
of
9, Utilities
I hereby certify that I have read and examined this application and have r
on reverse side, and know the same to be true and correct. All provision
type of work will be complied with whether specified herein or not. The
to give authority to violate or cancel the provisions of any other state or
performance of construction.
�'J
DATE /Y — / O ` / / SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
SPE AL CONDIT
DATE
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
Fire Marshall
JOB ADDRESS
Utilities
Zone Clearance
SEPA Checklist
LEGAL DESCRIPTION — SEE ATTACHED
�.
S
SUN
E" provilaws
and
LOT
BLOCK
SUBDIVISION
anti g of a
dSEWER
er doeal
PARCEL NUMBER/S
2.
w re
I
X25 1-15FoL�
Plumbing
OWNER
00
PHONE
Mech. _
ADDRESS
7'
Plan Check
ZIP
Required Set Backs in Feet
SEPA
S
Mobile Home
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
OFFICIAL
4'ADDRESS
ZIP
Type ConsTj
Occupancy
Sprinklered
Dyes ❑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
1-1 ALT.
ElAD'N. El RPL.
ElMVE.
7,
OF
El OTHER
11 BLD.
❑ PLMB.
❑ MECH: ❑ M.H.
El
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
8.0
VALUATION Source GAS ELECTRIC
of
9, Utilities
I hereby certify that I have read and examined this application and have r
on reverse side, and know the same to be true and correct. All provision
type of work will be complied with whether specified herein or not. The
to give authority to violate or cancel the provisions of any other state or
performance of construction.
�'J
DATE /Y — / O ` / / SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
SPE AL CONDIT
DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
FEES COLLECTED
PERMIT NUMBER
/ • [ l
DATE .12 0 �y
F S- - r
6 6 7
WATER
Single $
e "NOT
E" provilaws
and
dinan
Building
anti g of a
dSEWER
er doeal
w re
Ing const
Plumbing
00
Mech. _
7'
Plan Check
SEPA
Mobile Home
Other (Specify)
b0
TOTAL $.—
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
OFFICIAL
�' 7