1981, 10-27 Permit: 81B-1180 Woodburning 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
1. 5 2\4
LOT BLOCK
2. Q
13
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
5 124V ie....) 1Ac CP..es
OWNER
3.0
ADDRESS
2-.CAl4
PHONE
q 2 -ca p
ZIP
Gig?-oC
PARCEL NUMBER/S
:XS-544-
ZIP
XS-544-
Actual Set Backs in Feet
North •i 'South
East 'West
4.
CONTRACTOR
6
ADDRESS
DESIGNER
5. ADDRESS
PHONE
Size of Parcel Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
PHONE
V Iuation I Building Area in Sq. Ft.
Vit 5
ZIP
Main Floor
Upper Floors I1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
I.b NEW 0 ALT.
'"BLD. 0 PLMB.
❑ AD'N. 0 RPL. 0 MVE.
I1K/MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not 5teq'd.
DESCRIBE WORK
8.13uRiV
VALUATION SOURCE GAS
OF
UTILITIE•
S
w MASeONy e -1•416N-5, �1
LECTRIC WATER SEWER
Enum. Dist. I Location (Area)
Ownership I USE CODE
Public ❑ Private lig
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 INSPECTI9IS
DATE OF APPLICATION
io
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SIGNATURE OF APPLICAN "V‘e4C249 .117
(
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single S
Building' �G
Plumbing
Mech. O r ' �J
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
818 -- 1 k)
02* *1000
* 10.00
* 10.006
A p *0.00 8
117.82
10-27-81
2 6,479.
04* *1700
* 17.00 V)
* 17006
A *0.00 8
117.92
1.0-27-81
2 61479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11&Oz *27.00.20
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL