1979, 11-07 Permit M79-7465 Wood StovePLAN NUMBER
PERMIT NUMBER
SPOKANE COUNTY BUILDING CODES C)EPAI TMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE /%'• 7'" 79
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
B OCK
LOT
SUBDIVISION
OW ER
3. .�l)-4_P12.
A R ESS Q (
C . , s'(; / .5r ea,�.�
COT-RACTOR
DRRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
LI NEW
❑ BLD.
D CRIB WO��ffRK
8. 1/L. i�.l.l� A, e,( ' .J 'LA-C,
VALUATION S urce I GAS ELECTRIC I WATER
9. Utilities
❑ ALT.
❑ PLMB.
PHONE
ZIP
PHONE
PHONE
ZIP
TO
❑ AD'N.
II MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
Norlll (South
East IWest
Size of Parcel Zone Classification
Type Const.
Valuation
DWL Area
Split Entry
No. Baths
Occupancy
Basement Area
Sprinklered
Des DNo ❑ Req'd.
Building Area in Sq. Ft.
Garage Area I Storage
Spilt Level
No. Floors
CERTIFICATE
of EXEMPTION
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 /J-- 1
DEPT.
SPECIAL APPROVALS
REC'D. REC'D.
SIGNATUREN.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL COr\ DITIONS:
//-1--(Y ) )
DATE OFFICIA
APPROVED FOR ISSUANCE
No. Rooms
I
Rancher
Rec. Room
Req'd.
FEES COLLECTED
Single $
Building
Plumbing
),-,
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
U4*
47.00
*7.00
74642
1 1-07.-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS_RECOMES A PU MIT.
0 ' 7 7 '4 6, 5
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