1980, 10-02 Permit: M80B-1337 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
1. c:. / i / 1/414 uSr/o
2.
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
OWNER
3. ,41c4 l71
ADDRESS
CONTRACTOR
PHONE
ZI P
94
PHONE
Actual Set Backs in Feet
North !South [East 'West
Size of Parcel 1 Zone Classification
4. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
ales ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation 1 Building Area in Sq. Ft.
5. ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WO RK
TO
Area of Decks
Finished Basement
Unfin. Basement
Er-/NEW ❑ ALT. �,❑-,/AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. (iii/MECH. MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
8.jo,p ARtsrv_.�
VALUATION
9.
SOURCE
OF
UTILITIES
g a v
GAS ELECTRIC
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Rec'd.
Not Req'd.
WATER
SEWER
Ownership
Public ❑ Private ❑
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 APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshal
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
f /0A /eb
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech. O'
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
M
PERMIT NUMBER
u2*
*700
*7.00 N
*7.006
A *0,00
1 33.6
10 -02 -80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 2'_8'0'
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
1 '3 3, 7'5
PERMIT NO.
x7.00°
TOTAL