1979, 11-14 Permit: 79-7819 WoodstovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JO$ ADDRESS
. c_ to 5-/ v % *7
LEGAL 9ESCRjPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION
OWNER ��
3. sc4 d�� G �` ,
ADDRESS
cL
:.177
CONTRACTOR
CONTRACTOR
4.
ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
�53 80/ S3'
ZIP
PHONE
ZIP
PHONE
ZIP
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
lEast
West
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
Oyes ❑No 0 Req'd.
Valuation
DWL Area
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
O ALT.
O PLMB.
❑ AD'N.
MECH:
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
❑ OTHER
Basement Area
Building Area in Sq. Ft.
Garage Area
Storage
Split Entry - Split Level -Rancher
No. Baths No. Floors I No. Rooks Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
8.
DESCRIBE WOR
VALUATION
9.
Soyfce
of
Utilities
..g .�,�.t , j) ;e -
GAS ELECT IC WATER
SEWER
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
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
performance of construction.
DATE 4-- 7F SIGNATURE _
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
/1-141— 79 J/1I J/9 tJ a.41- 4,
DATE OFFICIALA
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
2)
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) ^
0�
TOTAL $ 7
PERMIT NUMBER
DATE /%-14-7`?
04*
B
781.82
11-14-79
2 6479.
*7.00
*7.00 Vi
*7008
*Q00
IMO
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
111-14L-79 i 9
*7,00ar-