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1979, 12-21 Permit: 79-9391 Wood Stove PLAN NUMBER APPLICATION/PERMIT ,�n PERMIT NUMBER SPOKANE COUNTY — BUILDING CODES DEPARTMENT 1 v \ -in J -(A NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 1 JOB ADDRESS/ 1 O� * * � O O (�' S� _(1 (� J LEGAL DERIP' ION — SEE ATTACHED LOT BLOCK ABDIVISI6N �1 L'' PARCEL NUMBER/S t 7 O 2. 4-% 2-253 * 7,0 0 6 OWNER i PHONE E * 0 G U 3. ADDR� T � Z �-lna�� 939.0 P Required Set Backs in Feet jO. cOj-ercyp__. North 'South East (West 1311.0-150..) CTOR PHONE Size of Parcel Zone Classification 1 2-2 1 -7 9 4. ICA.k.pnAgn L/s 9-5417&' b 4 7 9. ADDRES n ZIP Type Const. Occupancy Sprinklered z .1 3 V-01•0--) �1 . ')') ❑Yes ❑No ❑ Req'd. DESIGNER PHO E W-� 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. ❑ RPL. ❑ MVE. 7, OF ❑ OTHER WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd. of EXEMPTION DCSZBE WO 8. ., �/ (��._ �u� FEES COLLECTED VALUATION Source 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 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. Plumbing DATE SIGNATURE Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. REC'D. Plan Check Env. Health oc SEPA o Planning — w a. Mobile Home rn Fire Marshall — Co. Engineer Other (Specify) y Utilities C.-,0TOTAL $ { _ Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist L/ THIS BECOMES A'7PEnRMIT. z o O DATE/�.J2OJ OFFICIAL V�Ci.rtn./V.A1-1^ . 12 2 r- !,7 3 9.1 Z * 7. 0,L) 2 F-j- APPROVED FOR ISSUANCE _