1979, 11-01 Permit: 79-7147 Wood StovePLAN NUMBER APPLICATION/ PERMITPERMIITT
NUMBER
($�i 7-1 -1 Ili
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
Source
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
SEWER
JOB DRESS��z�
LEGAL P SCRIPTION — SEE ATTACHED
1 ��o�h
. "'
Will
LOTBLOCK
SUBDIVISION
PARCEL NUMBER/S
2. 3
N s LLCE6ST A,02 -E 2� ADD.
Single $
OWNER
3 G AEL-- 20
PHONE
Z�-2114
ADDRESS
ZIP
Required Set Backs in Feet
`
.. Z 2-0-L
9`121(oNorth
South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
A
SAi F.
DEPT. REQ'D. RECD. Plan Check
Env. Health
a.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Mobile Home
Fire Marshall
Dyes ❑No ❑ Req'd.
Utilities
$
TOTAL
Zone Clearance
WHEN MACHINE VALIDATED
'1 +
*
04*
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
DATE OFFICIAL --
APPROVED FOR ISSUANCE
* 7, 0 O V
5.
DWL Area
Basement Area
Garage Area
Storage
ADDRESS
ZIP
E * 0, 0 0 O
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
71 4,62
1 1-0 1 -79
TYPE Zr`
YJ NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF y� ❑ OTHER
❑ BLD. ❑ PLMB. 0 MECH: ❑ M. H. ❑ POOL
L �1
2 64.7 7,
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
lWORK
DESCRIBEFEES COLLECTED
$ JASA-ALL Woo Q UZI�I S+OV r r
VALUATION
Source
AS
ELECTRIC
WATER
SEWER
of
9.
Utilities
Single $
1 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 f c nstruction. 00
r
S IGNATU R Mech.
DATE
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities
$
TOTAL
Zone Clearance
WHEN MACHINE VALIDATED
IN
THIS BECOMES A PERMIT.
SEPA Checklist 1 i 1 0 , i; :n
"
DATE OFFICIAL --
APPROVED FOR ISSUANCE
i SPACE,
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