1979, 11-05 Permit M79-7259 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
%
LOT BLOCK
2.
-a-114-0-1
SUBDIVISION
OWNER
3 .m4,00 La
ADD,fjESS� I I. 1
at
CONTRA,�TO�'
4. ADDRESS
gYLT-09,11,
�39�1
PHONE
ZIP
5.
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North
South East
Size of Parcel
Type Const.
West
Zone Classification
SprInklered
❑Yes ❑No ❑ Req'd.
PHONE Valuation Building Area in Sq. Ft.
ZIP
TO
le/NEW 0 ALT. ❑ AD'N. ❑ RPL. 0 MVE.
❑ BLD. ❑ PLMB. MECH: ❑ M.H. 0 POOL
❑ OTHER
Split Entry
Garage Area
Split Level
No. Baths
No. Floors No. Rooms
Storage
Rancher
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
DESk2E_)(V_ O RK� I.
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.
DATE i//el /9 SIGNATUR f
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE // OF
FOR ISSUANCE
r
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
DATE
04*
*7.00
*7,00 In
725.8g
11-05-79
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11►-05'-7'9 72'5,'9z *7.00
0
IL-F.