1982, 01-27 Permit: 82A-667 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
1.
2.
3.
JOB 4.1DDRESS
LOT BLOCK SUB VISION
LEGAL DESCRIPTION — SEE ATTACHED
OWNER . Li'r6
AD EssL I
PHONE
e,2`2— 0‘63
CONTRACTOR
4. ADDRESS
Z147-1
PHONE
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South (East 'West
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation )Building Area in Sq. Ft.
ZIP
Main Floor I Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
CJ NEW 0 ALT. 0 AD N. 0 RPL. ❑ MVE.
0 BLD. ❑ PLMB. 12//MECH. 0 M.FI. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DES RIBE WORK
8.
VALUATION
9.
Enum• Dist.
Location (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
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 taw regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROV SPECIAL CONDITIONS:
NAME DATE
Env. Health a.
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Pian Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
-6) 0-7
04* *2000
*20.00
6668
0.1-27-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0('1-127-82
6 6.7 z
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. T;Tt\I