1980, 11-18 Permit: 80B-3936 Wood Stove0
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.011
PLAN NUMBER
10/
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
OB ADDRESS
L`o��8Lf3CK SU8Dt rs 0 -.A-1
2.
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
3.
L4 ��.t G�C' Pity
PHONE
DURESS
CO TRACTOR
4. A:44
ADJr7RESS ' n
DESIGNER
5. ADDRESS
ZIP
992�t
Actual Set Backs in Feet
North JSouth
'East
'West
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
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
NEW 0 ALT.
0 BLD. 0 PLMB.
❑ AD'N.
lg MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
ESCRIBE WORK 6/
11L
8. �L/I—
i '� ' / . 4/
VALUATION
9.
SOURCE AS
OF
UTILITIES
ELECTRIC
WATER
SEWER
Enum. Dist.
Ownership
Public ❑ Private 0
Location (Area)
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 othe
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION
DATE OF APPLICATION E-19-8?) SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning -
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
Blty.►ding Tec 'cion
cirect-A,0"
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $
PERMIT NUMBER
Sc8-39-%
C
*7.00
*7.00
*7,006
A *GOO'S
39352
11-18-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
319 16 V
PERMIT NO.
*7.004+ -
TOTAL