1979, 09-26 Permit M79-4736 Wood StovePLAN 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
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ADDRESS
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4' AD 9RESS
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
PHONE
ZIP
PHONE
ZIP
PHONE
ZIP
TO
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
Vorth (South 'East 'West
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
DWL Area
Split Entry
TYPE
7. OF
WORK
❑ NEW
❑ BLG.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
Basement Area
Garage Area
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
No. Rooms
Req'd.
DESCRIBE WORK
VALUATION
9.
/. ( 1 t 41,4'&6.C,L
Source
of
Utilities
GAS
WATER
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 - SIGNATURE —
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE OFFICIAL
Storage
Ranche
Rec. Room
FEES COLLECTED
Single $
Building
Plumbing
Mech. 7"
Plan Check
SEPA
Mobile Home
Other (Specify)
i
TOTAL $
if
DATE GT—; J — 747
PERMIT NUMBER
7 9- i71 73ro
04*
*7.00
*7,00 In
473,52
09-26-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09-26'-7.9 473,6z
*7.00;°1-2
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