1979, 10-26 Permit 79-6820 Wood StovesPLAN NUMBER
APPLICAAON/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
4.
JIB ADDRESS
OT
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
C
SUtSUI V ISIOUN
OWNER
t''{ Y..
ADDRESS
�f.L.;:::.� (_�e {4 /,rife)(
COEJTRACTOR
ADDRESS
DESIGNER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
PHONE
ZIP
r.2-j,.��l�
PHONE
ZIP
ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
Required Set Backs in Feet
North 'South East 'West
Size of Parcel Zone Classification
Type Const.
Occupancy
Valuation
Sprinklered
DYes DNo D Req'd.
Building Area in Sq. Ft.
DWL Area `Basement Area Garage Area
Storage
Split Entry
Split Level
Rancher
TYPE
7, OF
WORK
D NEW
❑ BLD.
O ALT.
❑ PLMB.
❑ AD N.
MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
D ASCRIBE WO9K,
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
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. �' ) J
DATE ID Z ll' ' 74,2 SIGNATUR :,
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
�
/ , , �> > t
DATF�C9'c�� %e/OFFICIAL �It,/./. V— (/''(!.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)si!
TOTAL $
M
PERMIT NUMBER
7V-- 6 g;!--
DATE/49`—:=:6-7c%
0 4 * *11.00
*11.00 i
681,92
10-26-79
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10'1— i2 6— 7' 9' 6 8 2, 0
1L.00�F-
APPROVED FOR ISSUANCE
U
NsI
- DR _REAN
ft' C it-0c
20' x 2 / r
n