1980, 09-05 Permit App: M80-9702 Woodburning 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 3 COPIES
JOB ADDRESS
LOT BLOCK 14646 d
2.
OWNER
3.
ADDR S
4.
6.
PHONE
7e-,!,5- / ZIP r/
CONTRACTOR ' 1 PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER /S
Actual Set Backs in Feet
North South East West
Size of Parcel
Zone Classification
ADDRESS
DESIGNER
ZIP
PHONE
Type Const.
Valuation
Occupancy
ADDRESS
ZI P
Sprinklered
❑Yes ENO ❑ Req'd.
Building Area in Sq. Ft.
Main Floor Upper Floors Garage Area Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths No. Stories
DESCRIBE WORK
8. odi)t9C/R/tilev l7
VALUATION SOURCE
OF
9. UTILITIES
5T7
GAS
ELECTRIC
WATER
SEWER
CERTIFICATE
of EXEMPTION
Enum. Dist.
No. Rooms
No. of Dwellings
Req'd. Rec'd.
Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
I hereby certify that I nave 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 co truction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS- , .
DATE OF APPLICATION `! '"5S "4'L) SIGNATURE OF APPLICANT /� 1
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B ding.,Tecl nicia
ti
LtiZ•a:��.
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. 4/ 7 g
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
L� L�
PERMIT NUMBER
04*
970,12
09 -05 -80
2 6,479
*7.00
*7,00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 9' 4015' 8E0"
DATE ISSUED
970,2z
PERMIT NO.
*7,00°
TOTAL