1980, 02-07 Permit: M80-953 Wood 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 4 COPIES
JOB ADDRESS
1 LOT
BLOCK
SUB IVISI N
LEGAL DESCRIPTION - SEE ATTACHED
3.
OWNER
ADDRESS
CONTRACT°
4. ADDRESS
PHONE
qa`3 -i7 a
ZI P
PHONE
PARCEL NUMBER /S
Required Set Backs in Feet
North 'South [East (West
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
DESIGNER
ADDRESS
PHONE
Valuation
ZIP
DWL Area I Basement Area
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft
Garage Area
6.
CHANGE OF USE FROM
TO
Split Entry
Split Level
7.
TYPE
OF
WORK
*NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ RPL.
ECH: ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
D ES C R I B E WO R K s7 _ croco
No. Baths
No. Floors
No. Rooms
Storage
Rancher
Rec. Room
Not Req'd.
CERTIFICATE
of EXEMPTION
olr
Req'd.
Rec'd.
9.
V ALUATION
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
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. (�
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env_ Health
Plan Wing
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
NOME OWNER'S WARRANTY
YTS Li
SPECIAL CONDITIONS:
DATE "aC' ( /OF FICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ f
4$ N\
DATE
PERMIT NUMBER
Sao °q53
04*
*7.00
*7,00
952
02 -07 -80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOM SAPgliMIT.
02_'-01 -.0 95.32 *7,00 O J
x1 -,
DATE REMARKS
r".
RECORD OF INSPECTIONS
Final Inspection
INSPECTED BY
C
*