1979, 12-28 Permit: 79-9584 Wood Stove ,PLAN NUMBER APPLICATION/PERMITPERMIT NUMBER
l 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
04 * * 7.00
JOB ADDRESS
1 (,J� , -ON LEGAL DESCRIPTION - SEE ATTACHED * 7.0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
* 70Cc)
2.
OW
`NER PHONE c E * 0,0 0 E.
,
3. k I(�),' ` +K\N 5 3✓ _4��
Required Set Backs in Feet 9 5 a 3
A DRESS
( 5 ZIPPNorth 'SouthEast (West 1 2-2 8-7 9
cTRACJOR PHONE Size of Parcel Zone Classification
4. h l Ili p s ,, 1 er vk-c L1.t.--.1.t.--._ ,. ‘--x 489-303 8 6 47 9.
ADDRESS
[ ZIP Type Const. Occupancy Sprinklered
`21
( 19F'Y-tC.,..►, is Dyes ❑No 0 Req'd.
r
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 0 NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. 0 PLMB. Ndl MECH: 0 M.H. 0 POOL
of EXEMPTION
DESCRIBER` WORK` (1 FEES COLLECTED
tel- SV
8. S\-CA, ,:, t ,J ik-ou-f {Ty �(_ -,Q 14C-_(
VALUATION Source GAS ELECTRIC WATER SEWER
of
g, utilities Single $
9 —
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.ns
,.
DATE( L ' . SIGNATURE` FA' 4� 1)„,_414.2 _,., Mech. 7.157C-
SPECIAL
57
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health o:
SEPA c)
I—
U
W
Planning d
Mobile Home
Fire Marshall
—
Co. Engineer Other (Specify)
Utilitiesb4
TOTAL $
Zone Clearance
WMACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS
HEN BECOMES A PERMIT. r n O ='
t� I 9 ,5n8. 4z * 7.UiiaH
DATE/a1 �� OFFICIAL f VVv��- 12 —'2 8 —7's
APPROVED FOR ISSUANCE - 1