1982, 10-11 Permit: 82A-9343 Wood StoveSize of Parcel
PLAN 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
LOT BLOCK SUBDIVISION
3.
OWNER
byi,r> �a
ADDRESS 2-7 AN( AL
CONTRACTOR
PHO
/ E
ro
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
4. ADDRESS
5. ADDRESS
DESIGNER
PHONE
ZIP
Actual Set Backs in Feet
North 'South
Type Const.
Occupancy
East
West
Zone Classification
CHANGE OF USE FROM
TYPE
7. OF
WORK
PHONE
ZIP
10
F NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. MECH. ❑ M.H. ❑ POOL
❑ OTHER
Valuation
Main Floor
Upper Floors
Area of Decks
No. Baths
D ESCRI BE WORK
kloe>t2 -(a \
WATER
VALUATION SOURCE GAS SEWER
OF
9. UTILITIES
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 C�
a g SIGNATURE OF APPLICAN v\
ELECTRIC
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Finished Basement Unfin. Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private ❑
No. Rooms INo. of Dwellings
Req'd. Rec'd.
'Location (Area)
USE CODE
DATE OF APPLICATION
SPELIAL APPROVALS
NAME DATE
Env. Health
Plann i ng
Fire Marshall
Co. Engineer
Utilities
Plans Examine
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. ^C7
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ -2(.9
PERMIT NUMBER
04* *20.00
*20006
A *0..00
934,22
10 -11 -82
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10.`1 82 93432 *20,00 °J- -
DATE ISSUED
PERMIT NO.
TOTAL