1982, 10-20 Permit: 82A-9880 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 3 COPIES
JOB ADDRESS
(42'2:2— 4 \JALt,v
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER /S
OWNER
3 O frk k'- .LLB1'L.
PHONE
ADDRESS q
� ? �{ZZX A ALc j1'•
ZIP
ciclzt (4,
Actual Set Backs in Feet
North 'South
4
CONTRACTOR
ADDRESS
PHONE
East
Zon
West
Size of Parcel a Classification
ZIP
Type Const.
Occupancy
DESIGNER
5. ADDRESS
PHONE
Valuation
ZIP
Main Floo
Sprinklered
Oyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Upper Floors Garage Area
Storage
('HANGE OF USE_ FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE NEW ❑ ALT.
7. OF
WORK ❑ BLD. ❑ PLMB.
❑ A ❑ RPL. ❑ MVE.
MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
V LUATION SOURCE GAS ELECTRIC WATER CI)
OF
9. UTILITIES
Enum. Dist. I 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 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 INSPECT!
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
,NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buildi nician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ Zr
771)
PERMIT NUMBER
a —\ 9 / O
04* *20.00'
*20,006
A *0.00
987.92
10 -20 -82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1.0 '-20 -8'2 988.Oz *20.00 -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL