1979, 08-22 Permit: 79-2631 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
M 7 ,,Q.‘„ /
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
4 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�4/y
//////' *7.00 V)
LEGAL DESCRIPTION - SEE ATTACHED Y
1 LOT ' BL /K� S BDIVI �/� PARCEL NUMBER/S *7.O 0 U
2. E * 000 8
OWNER (/�' J/�/[j /PPHONE _ t
3. '�' f�'/,{ Lk` y - ZIP r� 7g`9� Required Set Backs in Feet 2 6 3 0I
AD DRESSf
- /
'9Z,/, �1,7t<i_1/ y q,/K� North 'South East 'West 0 8_2 2_ 9
CONTR
RACT • 6 PHONE Size of Parcel Zone Classification $ a 4 7 9,
ADDRESS / /t/G 7 ZIP Type Const. Occupancy Sprinklered
3�R /31.: V 4 774(J L.l4 k l_,Qpa/0 4{sir,:-11,8 ❑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 0 ALT. 0 AD'N. ❑ RPL. 0 MVE. 1
7, OF 0 OTHER -
CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. 0 PLMB. �MECH: 0 M.H. ElPOOL
of EXEMPTION
DESCRIBE
$ 44 ) q� � �
FEES COLLECTED
VALUA IS rce 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 1,,•«:1 regulating construction o the Plumbing
performance of construction.
DATE — %-Z 7 SIGNATURE'
geMech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health c'
SEPA _)
,.)
Pianniny
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
UtilitiesJ 0
TOTAL $ 7`
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
��// )) � // /I,,�� THIS BECOMES A PE MIT.
SEPA Checklist DATED' 7(OFFICIAL �/� r 4_ _le'L. '�°' L'-� ? �, Z *7, O O a
APPROVED FOR ISSUANC