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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