1979, 10-22 Permit: 79-6470 Wood Stove PLAN NUMBER APPLICATION/PERMIT
M PERMIT NUMBER
77- 7U
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
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 ADDRESS /. ' --.e6, `. zetLEGAL DESCRIPTION — SEE ATTACHED *7.0 0
cii
1.
LOT BLOCK SUBDIVISION PARCEL NUMBER/S *7,Q Q v
2. E *Q00 n
OWNER PHONE
3 7,,2C‘—O5'-.6.e6469
ADD E S ZIP Required Set Backs in Feet �f n
7 -2---a6 North 'South East (West 1 0—2 2— ! 9
CONTRACTOR PHONE Size of Parcel Zone Classification
2 6,479
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
Elves ❑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 Cl NEW ❑ ALT. ❑ AD'N. 0 RPL. El MVE.
7. OF ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK CI BLD. CI PLMB. ❑ MECH: ❑ M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK FEES COLLECTED
8.
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
Plumbing
performance of construction. J
DATE
`d 02 -77 SIGNATURE!` :13 �-ei , Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health =
SEPA o
I—
c.)w
Planning 2
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Utilities
TOTAL $�/yf
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
OrdA P, THIS BECOMES A PERMIT.
SEPA Checklist DAT E/622ry7 77'OFFiAC, '�i - —n 2. 1 i 0 jn . l 0
APPRe' D FOR ISSUANCE _