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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