1979, 10-15 Permit: 79-6007 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
1. JOBADD gI1A00bV W 1 ,
LOT BLOCK SUBDIVISION' ('Z
2.
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
3 t,tJ Goo H
ADDRE S 5011
CONTRA TOR
4. �Mt3
ADDRESS
DESIGNER
5. ADDRESS
oma+ -AV JJ ;yz
PHONE
o571 -
PARCEL NUMBER/S
PHONE
Required Set Backs in Feet
North 'South 'East (West
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No El Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZI P
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
Lr/1 NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. E(MECH: ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8. DESCRIBE Wg �/
{ Source
of
9. Utilities
VALUATION
GAS
ELECTRIC
WATER
SEWER
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
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 constructs n
DATE (0e71—/ ? SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATEIO(I7// OFF
I
APP FOR FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
7 O"
TOTAL $
01
PERMIT NUMBER
- (o0
DATE
Olt*
*7.00
*700 rip -
6006
10-15-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-15-79 600.79
*7.00°H