1980, 08-08 Permit M79-7228 Wood Burn StoveLAN 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
JOB ADDRESS
ti y81 z IsewkAfer
LOT BLOCK SUBDIVISION
3. Owib BA ex LEY
ADDRESS
IV co.3 11- I5s J 4A t -T
CONTRACTOR
4. SAme
ADDRESS
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE
928- (L (p
PHONE
ZI P
PHONE
ZIP
TO
X.NEW El ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. gfMECH. ❑ M.H. ❑ POOL
❑ OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North ,South East (West
Size of Parcel
Type Const.
Valuation
DWL Area
Split Entry
DESCRIBE WORK
8. • LL. oo p = . Q. STove
VALUATION Source ELECTRIC
GAS
of
9. Utilities
No. Baths
Occupancy
Basement Area
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
Storage
No. Rooms
Req'd.
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 conduction or the
performance of construction.
DATE //— 2 22
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
1
DATE f( OFFICIAI.�V t ��r•_►�
APPR(lVFfl Ff1R 1S.5iHAN(;F
Ranche
Rec. Room
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Oo
Mech. .�
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
00
DATE
PERMIT NUMBER
-161 - Zz`c3
04* *7.00
*7,00 t6
*7.006
B *000 0
722,7g
11-02-79
g 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS COMES A PERMIT.
1R11-02`-7,9 72280
,*7.Q0Pi. F