1979, 11-13 Permit: 79-7746 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HA; D TO MAKE 4 COPIES C 4 * * 0 0
1
JOB DR sem�� i61T-1 LEGAL DESCRIPTION — SEE ATTACHED * 7.0 0 in
LOTS BLOCK SUBDIVISION PARCEL NUMBER/S 7 7 4 5 2
2. owiNgiztILI 1 1 — 1 3-79
ADDRESS /,,�I�I'I( p Required Set Backs in Feet
�7 �/ 1 �G North iSouth East iWest
CONTRAAT.O.t P ONE Size of Parcel Zone Classification
4' ADDRESS N ZIP Type Const. Occupancy Sprinklered
❑Yes ENo ❑ 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.
TYPE No. Baths No. Floors No. Rooms Rec. Room
NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. CIPLMB. MECH: 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
8. DESCgIBE„W.QRK ��
fj',��IIC�``�`JyV) 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 I ws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The g ntin of a permit does not presume
to give authority to violate or cancel the provisions of any other state or I cal law regulating constructik o the
performance of onstru 7ion. /, "'Plumbing
y V �7� CJ1l
DATE l/ /3 / / SIGNATURE_ ) Mech. `
i
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. RECD. REC'D. Plan Check
Env.Health
z
SEPA i-
Planning - u
0
Mobile Home Cl)
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist ftweill A r
THIS B COM A 7PE,�iMIT. •!
DATE/1/23 FFICIAL` 11 —� ./ r' ( 4 Z 4 7,O O
A '! ; 1R ISSUANCE —