1980, 08-14 Permit: 80-8550 Wood StoveSize of Parcel
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
v
463606-srLOT BLOCK SUBOIVISION
2.
OWNER
3. R/ees/
ADDRESS
�EN�S
S_ /30 4/ algIllftelbt
CONTRACTOR
s,49mE
ADDRESS
J�i9/I�F.
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TO
ZIP
ZIP
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South East 'West
Zone Classification
Occupancy Sprinklered
❑Ves ❑No 0 Req'd.
Building Area in Sq. Ft.
Upper Floors 1 Garage Area
Storage
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
l!7 NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
❑ BLD. ❑ PLMB. U7 MECH. 0 M.H. 0 POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIBE WORK
8. A—bap Bert/6•.STb c/c
9. I�ITIE�v
VALUATION OURCE GAS ELECTRIC
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 constructi,_ or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SPECIAL AP°ROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buildi g Technician
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
Qo
$ -2. 00
PERMI',' NUMBER
g0-.5 SZ3
04* *7.00
*7.00 6-5
*7.006
E *0.00 S
854.92
08-14-80
y. 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 81-'1.4 8'0
855,05 *7.00°1
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
FII F (:()PY