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1982, 10-08 Permit: 82A-9292 Woodburning Insert
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 ZZ 1. r.�ct EtJ LOT BLOCK SUBDIVISION OWNER 3. �'"'CJC.• ADDRESS PHONE ZIP c 4a 3.7 CONTRACTOR PHONE a SArh,E • ADDRESS DESIGNER ADDRESS 6. CHANGE OF USE FROM TYPE 7. OF WORK NEW ❑ BLD. ZIP PHONE ZIP TO LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER /S Actual Set Backs in Feet North (South East West Size of Parcel Zone Classification Type Const. I Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. Valuation Building Area in Sq. Ft. Main Floor I Upper Floors Area of Decks No. Baths No. Stories ❑ ALT. ❑ D'N. ❑ RPL. ❑ MVE. ❑ PLMB. I MECH. ❑ M.H. ❑ POOL ❑ OTHER DESCRIBE WORK 8.(.L;)(7 rw i 1210 w '� 9. VALUATION SOURCE OF UTILITIES NEE tZ"t GAS ELECTRIC WATER Garage Area PERMIT NUMBER 04* *2000 *20006 A *0.00 92912 10 -08 -82 z 6479. Storage — Finished Basement Unfin. Basement CERTIFICATE of EXEMPTION Enum. Dist. I Location (Area) No. Rooms Req'd. 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 INSPECTIONS O DATE OF APPLICATION' 1©„ O.. &J- SIGNATURE OF APPLICANT SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Enginee Utilities Plans Examine SEPA Checklis Building Technician �"' ;i %a_ V g 'ff SPECIAL CONDITIONS: PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE No. of Dwellings Rec'd. Not Req'd. FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ Y�i/ •�XJ WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 10.08 -82 929,22 *20.0 0 2 pi - DATE ISSUED PERMIT NO. TOTAL