1979, 12-06 Permit: 79-8778 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COON
TY — BUILDING CODES DEPARTMENT / 7"—' 7
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE ,/,Z-60.— 79
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESSO4* * 7.00
LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK SUBDI ISION PARCEL NUMBER/S
2. I 877.72
OWNER - Xpvtu� PHONE 1 2-0 6=7 9
3. isi .t. �( X1,1 ;�t P.--A-Gt - ci<Z Fl-6 i
A RESS ZIP Required Set Backs in Feet 2 6 4 7 9
l.z /`,:i;W- igx-i,a {�,,,�— i .!t�,f 1 g � 1 C- North (South as
West
E COJjITRACTOR �l PHONE Size of Parcel Zone Classification
.C%: ,vL
4' AD,pRESS ZIP Type Const. Occupancy Sprinklered
-142 P.__ Oyes ❑No CI Req'd.
Dim
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area Basement Area r 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 CERTIFICATE Req'd. Recd. Not Req'd.
WOVK Cl BLD. ❑ PLMB. l MECH: ❑ M.H. El POOL
of EXEMPTION
DESCRIBE WORK . FEES COLLECTED
8.. ,"t . �t
/1/4 ..ek- .) fy'� l .4_4)-6-t,.
-6- -Gl../b—C4.-ii-i.,.4.--;.'.‘4,-,ja-i1—
VriLUA1"ION l ource GAS ELECTRIC WATER SEWER
of
lof
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 Jaw regulating construction or the
Plumbing
performance of construction.
DATE1:2_—6, 7 SIGNATURE �,' �""(
� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health CC
SEPA CD
I—
_ v
Planning L+J
0-
Mobile
Mobile Home
Z
Fire Marshall
Co. Engineer Other (Specify)
Utilities '�
TOTAL $ /
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /.2---(.0– THIS BECOMES A PERMIT.7`� 110817 7.8 Z * /,O�O�,aH,,
DATE OFFICI• . di ,.._../.1 / . n , 12 = 06 '-7 9 7
APPROVED FOR ISSUANCE —