1979, 10-08 Permit: 79-5479 Wood Stove 'IPLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT PI 7 — 54-7
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 4* * 7.0 0
JOB ADDRESS0p., �i'la LEGAL DESCRIPTION - SEE ATTACHED * 7,0 0 n
LOT BLOCK SUBDIVISION PARCEL NUMBER/S + * 7.0 0 v
2.6,7 17 N L rA `—A-I 2_--(et3-r' E * 0.0 Q
OKNER PHONE
3. Imo' I41. 1„6 ,20- c36°, 547.82
ADDRESS ZIP Required Set Backs in Feet
70O L("& -).__NV North 'South [East west 1 0-0 8-7 9
CONTRACT R PHONE Size of Parcel Zone Classification
q\IVI
2 6479,
4' ADS 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 ❑ ALT. ❑ AD'N. I=1 RPL. ❑ MVE.
7. OF ❑ OTHER Req'd. Recd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. MECH: l: M.H. 0 POOL CERTIFICATE
of EXEMPTION
DESCRiI-�E WORK
8. YV 0019 r kI1 Ii\I 1v\/ FEES COLLECTED
VALUATION Source ✓ I 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 �� vv
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
performan a of construction. Plumbing
E\-
7- --2
DATE l _ g'.--- SIGNATURE •-•1•�(' Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health r.
SEPA r'D
J
Planning 1
Mobile Home
Fire Marshall '—
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist 1!1// //
THIS I1BECOMES IA PERMIT.1 /I 7 ff11
DATE'%8/ OFFICI• �It s' ..-
�i� 1 O �'O 8 79 4 7. 7 Z * 7.0.� d r —
(/ �/ APPRO OR ISSUANCE