1979, 12-10 Permit: 79-8866 WoodstovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
V
BLOCK
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
SUBDIV SION
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
3
OWNER
ADD .
CONT
Required Set Backs in Feet
North South East West
Size of Parcel
Zone Classification
4. ADORES
6.
DESIGNER
ADDRESS
CHANGE OF USE FROM
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
DES RIBE
ORK
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
Type Const.
Valuation
DWL Area
Split Entry
No. Baths
Occupancy
Basement Area
Sprinklered
Elves ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Split Level
No. Floors
S
orage
Rancher
No. Rooms
0 OTHER
CERTIFICATE
of EXEMPTION
Rec. Room
Rec'd.
Not Req'd.
8.
VALUATION
9.
Source
of
Utilities
ELECTRIC
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 construction.
DATE 10-6 761
DEPT.
Env. Health
SPECIAL APPROVALS
REQ'D.
SIGNATURE
SPECIAL CONDITIONS:
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
kl-71
ist
DATE
OFFICIAL `'47
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
(j --')f0
TOTAL $ J O
70
DATE
I NUMB7r6(octo
04* * 1 0,00
* 1 0.00 b
* 10.006
E *0.00
88652
12-10-79
2 6479.
U
— w
a
z
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12'-10--;79
886,6 *10.002-12