1979, 11-06 Permit: 79-7380 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.
2.
3
JOB ADDRESS
LOT
430 ( 3!p
SUB VISION
BLO
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER
R- 3. SMI K06
s(AMf$4.
ADDRESS
4.
CONTRACTOR
sAw
ADDRESS
PHONE �/
4'w -i9 7T
ZIP
CM 2_0.3
Required Set Backs in Feet
North 'South
East
'West
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ENo ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZI P
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
L - EW
❑ BLD.
❑ ALT. ,❑,, Aim.❑ RPL. ❑ MVE.
E
❑ PLMB. 1 CH: 0 M.H. ❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. Gtrt)D S
VALUATION
10 4:62-
9r
9.
/r5 TALi-A-710N(
Source GA
of
Utilities
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 I•. -1 law regulating construction or the
performance of construction.
DATV SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE ii -42:7q OFFICIAL J'rs6:8'
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
7,
TOTAL dig
PERMIT NUMBER
7340
DATE /1—‘"--77
04*
*7.00
*7.00 rri
737.9
11-06-79
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11-06-79
738,02