1979, 07-16 Permit: 79-490 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 1
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES – PRESS HARD-TO MAKE 4 COPIES 0 4 , *7.0 0
JOB ADDRESS '
1. 10. 2,60/ fi NI l3p LAll LEGAL DESCRIPTION – SEE ATTACHED *7.0 0 N
LOT BLOCK SUBDIVISION PARCEL NUMBER/S L a 9 2
2. '?Ci'1. -- Q 3c)q
OWNER { � HONE 0 7 4 6 7 9
3. •=5-- __,04-- 1- 61479.9
ADDRESS ZIP Required Set Backs in Feet
Gly 2'607 11 1,1 1ja9..,.. yAsH r2North (South East IWest
CO Ni
e of Parcel
4' ADDRESSVil � � Ov. Vk S PHONEISType Const. Occupancy Zone ClasSpr ntkloered
Eves ENo ❑ 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. 0 AD'N. 0 RPL. 0 MVE.
], OF ❑ OTHER
WORK 0 BLD. 0 PLMB. MECH: 0 M.H. 0 POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
8. DESCRIBE WORK15' kr r '�OV '
WFEES COLLECTED
VALUATION Siource 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 SIGNATURE I Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. , I I� /_
2I� Plan Check
���� ' tV
Env.Health rGj (;I
IAG1lIl [/ 11\1 SEPA o
c
N
Planning C
—
Mobile Home 0
Fire Marshall 2
o
, D
Co. Engineer Other(Specify)
Utilities
TOTAL $_
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist ' r. THIS BECOMES[ A PERMIT.
DATE 1V..77 OFFICIAL '�1 O 7 - 111_7 9 *7 O 0 a
APPROV 1 foR ISSUANCE