1981, 12-03 Permit: 81B-2386 Shop Stove(PLAN NUMBER
Ir
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.
JOB ADDRESS
N 3 ‘ bs
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
OWNER
3. L.
ADDRESS
N. toQ,
CONTRACTOR
4- ADDRESS
SawtC
PHONE
ZIP
PHONE
PARCEL NUMBER/S
Actual Set Backs in Feet
North [South [East 'West
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinkiered
❑Yes ❑No ❑ Req'd.
5.
DESIGNER
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
U NEW 0 ALT. ❑/JAD'N. ❑ RPL. 0 MVE.
❑ BLO. 0 PLMB. CJ MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. t a1iE
VALUATION SOURCE
OF
9. UTILITIES
L 1 u � � SO (X:1-5 "3 �a
ELECTRIC WATER SEWER
GAS
Enum. Dist.
Location (Area)
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
DATE OF APPLICATIOT4l / 2 w / SIGNATURE OF APPLICAN
SPkCIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu iding Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech. 44 V9 ,c
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
83-2-38c,
04* *1600
*1600 ti
*1600'6
A *0.00
238.32
12-03-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
121-03.1-81' 238,65 *16.0021
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
PERMIT NO. TOTAL