HomeMy WebLinkAbout1979, 11-14 Permit: 79-7808 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
2.
JOB ADDRESS
31 c1 14- •
LOT SUBDIVI ION
BLOCK
LEGML DEtCRIPTION - SEE ATTACHED
OWNERrN
3.}
ADDRESS
PHONE
q 2 -
PARCEL NUMBER/S
ZIP
4.
CONTRACTOR
PHONE
Required Set Backs in Feet
North
Size of Parcel
South
'East West
Zone Classification
ADDRESS
DESIGNER
5' ADDRESS
ZI P
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
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
D NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. (� o-()-4).
VALUATION ELECTRIC
9.
Source
of
Utilities
G4S
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 construction.
DATE
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE /I �7— OFFICIAL A1142:7174/24
APPROVED FOR ISSUANCE —
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
DATE
PERMIT NUMBER
M6-11 � O
04* *7,00
*7.00
*7.006
B *0.00 0
780.72
11-14-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1'1-14 -279 780.85
*7.00°1=