1982, 12-27 Permit: 82B-2217 Wood 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.• / G 5_. i4.S
LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK
SUBDIVISION
PARCEL NUMBER/S
NER
3 et)/r A/19 1- 2 Al 6 EL
ADDRESS
4• : iE- s
PHONE
9'c?' -/t,
9a° G
Actual Set Backs in Feet
North !South !East West
CONTRACTO R
4. AP D R ESS ,l1
I/v ' � / � / V AS • O nJ
PHONE
4/1-' -/, / 7
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes 0 N ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area In Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfln. Basement
TYPE
7. OF
WORK
NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
0 BLD. 0 PLMB. rm✓ECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
O�SCRIBE WORK
•
VALUATION SOURCE J ELECTRIC
OF
9. /0"0 d UTILITIES
GAS
WATER
Enum. Dist.
Location (Area)
SEWER
Ownership
Public ❑ Private 0
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 APPLICATIONA'7
awq
SIGNATURE OF APPLICA��.C�� l�G
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Recd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
moo.
PERMIT NUMBER
04* *20.00
*20.005
A *Q00
221.6
12-27-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1i2-2,7-,8'2 22L75
*20,OOo
a_I-
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
Fii c C1113V