1979, 12-19 Permit: 79-9325 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER I
SPOKANE COUNTY - BUILDING CODES DEPARTMENT M7, r `-`.7
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS z 0 4 * *7 0 0
1. -<92 0 i �� LEGAL DESCRIPTION - SEE ATTACHED * 7 101 0 tii
LOT BLOCK SUBDIVISION PARCEL NUMBER/S *7 L 0 U
2.
OWNER ' ff PHONE
3. N K' r�GI n 2- 922— 1 a--1" E * 0.0 G
ZIP Required Set Backs in Feet 9 3 2.4 2
ADDRESS
2�' �- -2--4 CP North 'South East (West 1 2— 1 9—7 9
CON RACTOR PHONE Size of Parcel Zone Classification
4. GUMC 2 6479,
ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
FJ. 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 IrNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF111OTHER Req'd. Recd. Not Req'd.
WORK
0 BLD. ❑ PLMB. l MECH: ❑ M.H. ❑ POOL CERTIFICATE
of EXEMPTION
DESCRIBE WORK
8. N0M0 FEES COLLECTED
VALUATION I 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 ir local law regulating co,e0 ruction or the
performance of construction. f , Plumbing
DATE 42-19— // 9 SIGNATURE .ii-i 1/_. //1 i �--- c''‘2Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health cc
SEPA a
1.--
Planning
—Planning
u
2
Fire Marshall Mobile Home -.
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /---/-J/77�/''�i THIS,BCOM ES A PERMIT. � (1
DATE /..7,4Y-
OF- AL [.' - _ _.. ,_ —`1. i — 7 2. 5 * 7, 0 0 rT. f
AP••: . a FOR ISSUANCE