1979, 11-01 Permit: 79-7085 WoodstovePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK IbUt3UIVIPIUN i PARCEL NUMBER/S
MPERMIT NUMBER II
DATE ' //`
04* *7,00
*7.00
*7.006
B *0.00
70a4�
11 =01 -79
;@ 6.479.
VALUATION Source AS E EC IC WATER SEWER
OWNER
of
Q. Utilities
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
PHONE
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
3.
�'
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
'.,
performance of construction.
}�
'
DATE C2 SIGNATURE
ADDRESS
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT, REQ'D. RECD.
ZIP
Required Set Backs in Feet
�6,
Planning
�t�
Mobile Home
North South
East West
Co. Engineer
CONTRACTOR
Utilities
PHONE
Size of Parcel
Zone Classification
v
SEPA Checklist 1/ ` y --7/�J� /y� /7
F� /
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THIS BrOMES A PERMIT. n R
7
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4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
-J,a ., �
❑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 1:1 NEW
El ALT.
1:1AD'N. ❑ RPL.
1-1MVE.
7,
OF
1:3 OTHER
❑ BLD.
❑ PLMB.
MECH: ElM.H.
❑POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
8
_
FEES COLLECTED
�
f �
� ' %-
MPERMIT NUMBER II
DATE ' //`
04* *7,00
*7.00
*7.006
B *0.00
70a4�
11 =01 -79
;@ 6.479.
VALUATION Source AS E EC IC WATER SEWER
of
Q. Utilities
Single $
1 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 C2 SIGNATURE
Mech. �=
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT, REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Utilities
TOTAL
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist 1/ ` y --7/�J� /y� /7
F� /
�YALiL/
THIS BrOMES A PERMIT. n R
7
O "� / 0 "• 5 Z
n n n F F i r i n rA I / ,'7f /:l/J .�Li•
*7.0.0a-a:I-