1982, 09-03 Permit: 82A-7855 WoodstovePLAN 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
1.
2.
3.
4.
5.
JOB ADDRESS
LOT BLOCK
OWNER
TDAJto
ADDRESS
(6t.?
CONTRACTOR
Aires- E3
ADDRESS
DESIGNER
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
PHONE
Y Ooec
PARCEL NUMBER /S
ZIP
-P&& s. caste -c .c�
Actual Set Backs in Feet
North (South
East
(West
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
ales ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N. ❑ RPL. ❑ MVE.
❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. UI j To 0C
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
Enum. Dist.
Location (Area)
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 ranting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local la egulati cori tion or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED I PECTIONS
DATE OF APPLICATIOI - 3--80 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building 7.45„,„
Plumbing
Mech. * `��_
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $4a -'
PERMIT NUMBER
$2 A-765.5-
02* *20.00
04* *2000
* 4000
* 40.008
A *000
78548
`09 -03 -82
g 6.479 -
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 °9 0 5 - 8 2'
DATE ISSUED
785.55
PERMIT NO.
*40.00 °°
TOTAL