1981, 11-05 Permit: 81B-1511 WoodstovePLAN NUMBER
j i
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
•
LOT BLOCK SUBDIVISION
3 iQ, 41W- ?, 7
OOF G yL'
CONTRACTOR
4' ADDRESS-
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/St,',,FO r +ci,1s fy r'T crF 13 111
Ni &d& (, i 6.61- )V,,z5'
/di. y3 - -3
Actual Set Backs in Feet
North 'South East (West
ESIGNER
ADDRESS
CHAS E OF USE FROM
6.
TYPE .. IEW
7. OF ��
WORK ❑ BLD.
PHONE
ZIP
PHONE
ZIP
TO
❑ ALT. ❑E AD'N. ❑ RPL. ❑ MVE.
❑ PLMB. /MECH. ❑ M.H. ❑ POOL
❑ OTHER
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
Oyes ❑NO ❑ Req'd.
Valuation
Building Area in Sq. Ft.
Main Floor
Upper Floors 1 Garage Area
Area of Decks
Finished Basemen
Storage
Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE W RK
ELECTRIC WATER
VALUATION SOURCE GAS
OF
9. UTILITIES
SEWER
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private ❑
Req'd.
USE CODE
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION //
SIGNATURE OF APPLIC
SPECIAL APPROVALS ' SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Tec a
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
(7
PERMIT NUMBER
— l
04* *17,00
* 17.00 to-
* 17.006
A *0.00 8
151.02
11-05-81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1p1 -05
DATE ISSUED
81
151.15 *17,000
PERMIT NO.