1979, 10-24 Permit: 79-6590 Wood Stove PLAN NUMBER APPLICATION/PERMITn
PERMIT NUMBER
7y- - 6'5,e2SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATEht—7 /q
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 4 * *7.0 0
JOB ADDRESS j� * ],0 0 N
1. S_ 11:710S—‘ \c/k.),A4RR� �C UprD LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDISION PARCEL NUMBER/S *7.0 0 U
2. E *Q00 0
OW PHONE
3. Rbilz-rtr C&) . MALL Dy '726 -8913 65598
ADDRESS ZIPRequired Set Backs in Feet
S- L(0S &J A-R.2e-N p_0-A'0 75)..2/ 6 North 'SouthEast 'West 1 0-24-79
CONTR TOR PHONE Size of Parcel Zone Classification Q 4 7 9
4' ADDRESS �� ZIP Type Const. Occupancy Sprinklered
Oyes ❑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 *MALT. ❑ AD'N. ❑ RPL. ❑ MVE. -
7. OF ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK D BLD. ❑ PLMB. vz MECH: D M.H. C7 POOL
of EXEMPTION
DESCRIBE WORK
8. Vi 00 • Tovf' /A .S1 ALL 6770 n1 FEES COLLECTED i
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 or local law regulating construction or the
performance of construction. 01111F Plumbing
DATE 7Q--2 4-7 7 SIGNATURE 1 i 0�
�% l �r�-(Y�� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health r
SEPA o
f—
,
— w
Planning a
Mobile Home Cl)
Fire Marshall =
—
Co. Engineer Other (Specify) 7Utilities TOTAL $ .,
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /J/�/ THIS BECOMES A PERMIT.
7 (�
w/�— OFFICIAL . -1,,— t�Z�' �. �' — f �� 7 `; J %� �, �� * !, U O f=
DATE/9 7T ``
APPROVE/ FOR ISSUANCE —