1979, 10-03 Permit: 79-5198 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 HARD TO MAKE 4 COPIES
ar — 04 * * 7. 00
JOB� ADDRESS J d11Z
1LEGAL DESCRIPTION — SEE ATTACHED * 7. 0 0
LOT �� CK SUBDIVISION PARCEL NUMBER/S 5 1 9.7 2
2.
OWNER PHONE 10-03-79
At iii
,it-) SCHP/ / fl� '12e. 6013
3 ADDRESS _Ad— ZLy/Q Required Set Backs in Feet 2 6 4 7 9.
2-._--7—' l// 2) 22 f ����7 North (South East (West
CON PHONE Size of Parcel Zone Classification
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
I0 yes ❑No E Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
—
5. ADDRESS ZIP OWL 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 CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK FEES COLLECTED
VALUATION (Source GAS ELECTRIC WATER SEWER
c9-C2 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.
DATE /C)____/4/7-9 SIGNATURE -7. 0
D
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health �'
SEPA `0
r.7)w
Planning 0
Mobile Home
Fire Marshall
Co. Engineer Other(Specify)
Utilities
TOTAL $ • C262
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
DATE 16(-372 OFFICI•. — - 10 0 J — /79 -
APPRO 4 D OR ISSUANCE