1979, 11-28 Permit: 79-8435 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER )
SPOKANE COUNTY - BUILDING CODES DEPARTMENT H 7q_ r
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE ' >' g' � ?
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
04 * * 7.00
JOB ADDRESS
/4,�&, �V� 4Y(t��Q -i--• LEGAL DESCRIPTION - SEE ATTACHED *7,0 0
LOT BLOCK S BDIVI IO PARCEL NUMBER/S 8 4 3.4 @
2. O (l
OWNER /, PHONE 1 1 -2 8 �7 9
r
3. (7_444.61.., i L_.D-{�_.Ci/ -� , yf`=1;-t
ADDRESS �'7` J/�/)) //��} ! %Z/,,,Q7ce,� °, ZIIP Required Set Backs in Feet 4 7 9,
sk; ZA 01n v__!%t?/L Q.-1.P.ar Lt.. /&_-fes ��,t!IZ" _/9&i 7 North 'South East
CONTRACTOR PHONE Size of Parcel Zone Classification(West
ADDRESS ZIP Type Const. Occupancy Sprinklered
S)., .vLLt� Dyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP OWL Area Basement Area( Garage Area Storage —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
TYPE No. Baths No. Floors No. Rooms Rec. Room
❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER J
WORK CIBLD. ❑ PLMB. NZ MECH: CIM.H. ClPOOL CERTIFICATE Req'd. Rec'd_ Not Req'd.
of EXEMPTION
DE CRIBE WORK
�1 ;7V-el-.441
7V�¢ nc - ,t '
FEES COLLECTED
8. •l� �,1
v, I.rt,�L'�c
-° .�+-��.�� rL. .c�� v>rCfe /4� I�7.e-
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 olocal law regulating construction or the
performance of construction. //,r /J ,}{ /' �� Plumbing
Ni
DATE 1/— -, � l .4001--����%''G�l/'_, a ,�
�jf— SIGNATURE L Mech.
SPECIAL APPROVALS SPECIAL CON ITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
c
SEPA c
Planning c
_ L
c
Mobile Home c
Fire Marshall
Co. Engineer Other(Specify)
Utilities ! o'er
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist _ .� 7 //,/�,✓11 p? y � THIS BECOMES A�P]ERMIT. '7
DATE....., OFF ICIAL„'1`�'L'( i `Aa-vf--titX- .�.��.r2 ��:1'(1'� C} ��� *./. O,O O
a
APPROVED FOR ISSUANCE _