1979, 09-26 Permit: 79-4740 Wood Stove PLAN NUMBER APPLICATION/PERMITPERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
M 7 °7— 4 7i
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE_ ' `
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 04* *7.0 0
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED *7.0 0 .-
1. c„,-6' T BL Ki ,ICle
OT BL CK SUB IVISION PARCEL NUMBER/S *7,O 0 U
2. c
O ER E
PHONE *Q00 cbU
3. ,(////e,,,)-- e ....z, y. &v/b' -C 473.98
ADDRESS ZIP Required Set Backs in Feet
lJ 1� f/11�Q� C7 _ _ c/� � North _South East 'West 0 9—2 6-7 9
C NTR CT R 7'_ PHONE Size of Parcel Zone Classification
4. ( ` / L��-`z,Q, c c4 .cihu > fit. 6�4 7 9.
/���ttt/tf�}RES / ,�{�J ^` ZIP Type Const. Occupancy Sprinklered
' i 64:5' _N ,F-4-;/ J�- .., f_qat/J ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area I Basement Area Garage Area I 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
WORK CIBLD. CIPLMB. ❑ MECH: CIM.H, CIPOOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8 f (`�}�� 1 -/Zib� FEES COLLECTED
VALUATION Source GAS ELECTRIC I WATER SEWER
of
9, Utilities
Single $
—
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 construction or the
performance of construction. a Plumbing
DATE � zr SIGNATURE �
,--/ - id."------ Mech. ,7_
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health rz
SEPA O
1—
Planning — w
a.
Mobile Home
Fire Marshall z
Co. Engineer Other (Specify)
Utilities if
.��1>
TOTAL �"
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT. `g * J
DATE OFFICIAL 0 2 6 - 9 47 4 0 7, O 0,2O
APPROVED FOR ISSUANCE