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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 .A 7, 0 0 ° �- ce O co U co