1979, 11-20 Permit: 79-8185 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER 1
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 71 — V 5��,
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 DATE ✓i-- '4
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
04 * * 7.00
J.:/= ADDRESS • LEGAL DESCRIPTION - SEE ATTACHED
* 700 v?
1. .. -Z. ' ,r.-� r-�.1 �.�k . PARCEL NUMBER/S
LOT BLOCK SUBDIVISION
2. 81U4
OWNER PHONE 1 1 —2 0-7 9
3. a/✓' ,/.Z1.1,41- > -act- , 7 6 nn
RESS ZIP Required Set Backs in Feet 4 7 7.
-/9 4-6 2416-44-4a- 9q.0 North 'SouthEast IWest
CONTRACTOR PHONE Size of Parcel Zone Classification
4' AD RESS ZIP Type Const. Occupancy Sprinklered
.41ti— DYes ❑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 ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. xi MECH. ❑ M.H. ❑ POOL
of EXEMPTION
DESCRIBE�(WORK '''/�J{'/ `�� C�� FEES COLLECTED
8. TION -1 Source 4-4 yGAS ✓41�✓/1 " ELECTRICVALUAWATER SEWER
of
9. Utilities Single $
9 —
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 con ucti.n or the
performance of construction. '� .'y ' ' Plumbing
DATE / /—2-0— 79 SIGNATU' _ / Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health r.7v
SEPA
J
Planning — �''u
2
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities D e
TOTAL $ 7.—
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES((��A PERMIT.
SEPA Checklist DATE �D L� OFFICIAL A/4LirAL. 1 1 (20 / 9
/!_ c: SS18. 5 *7. 00a. �
APPROVED FOR ISSUANCE _