1980, 09-15 Permit: M08B-0190 Woodstove(PLAN NUMBER
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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 k , v. —S�Jr 17 A-1,1 1. I C! c
LOT BLOCK SSUBDIVIS ON /��
' r i F IVi k- i 1 -4A x7
PH N
OWNER
3.05
AD .
"s".7
4.
CONT AC;
ADDRESS
DESIGNER
5. ADDRESS
OR
L
Po'I
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER /S
Actual Set Backs in Feet
North South East
Size of Parcel Zone
ZIP
Type Const.
West
Classification
Occupancy Sprinklered
❑Yes ENo ❑ Req'd.
PHONE
Valuation Building Area in Sq. Ft.
CHANGE OF USE FROM
ZIP
Main Floor
Upper Floors Garage Area
TO
Area o
Decks
Storage
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
ALT' NEW ❑ ALT. ,El AAD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. Kd' MECH. ❑ M.H. ❑ POOL
DESCFRIBE WORK
8. r C/,/t
VALUATION SOURCE GAS
9. UTILITIES
I ELECTRIC
O F
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
WATER
SEWER
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private ❑
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 INSPECT`NS
SIGNATURE OF APPLI,
USE CODE
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examine
SEPA Checklist
FEES COLLECTED
Single $
Building
Plumbing
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
la r Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
r f v
PERMIT NUMBER
?� F - 0'42'0
04*
A
1892
09 -15 -80
6479,
*7,00
*7:00 to-
*7,006
*000
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
�p 9. 1;5'' °!B,,U
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
19,0 z *7,C0°I
PERMIT NO. TOTAL