1981, 09-30 Permit: 81B-064 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
N 2 010 gi4EAyt Be -ss:
LOT BLOCK SUBDIVISION
OWNER
s-TRN uN0
PHONE
R1 -5)72?
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/5
ADDRESS
�. 2010 BE-SS/E.
ZIP
Actual Set Backs In Feet
North (South
East
West
4.
CONTRACTOR
ADDRESS
PHONE
ZIP
DESIGNER PHONE
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
ZIP
TO
erNEW ❑ ALT. D�AD'N. ❑ RPL. 0 MVE.
E
0 BLD. 0 PLMB. MECH. 0 M.H. 0 POOL
0 OTHER
Size of Parcel
Zone Classification
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Main Floor
Building Area in Sq. Ft.
Upper Floors 1 Garage Area
Storage
Area of Decks
Finished Basement Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd. Rec'd.
DESCRIBE WORK
WOOD s-roVE rNS`fAL.fgTI
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATE R
SEWER
Enum. Dist.
Location (Area)
Ownership
Public 0 Private 0
USE CODE
1 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 APPLICATION
1-30—qs(
SPECIAL AP?ROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
7%
Other Specify) /O M'c
TOTAL $ 17 --
PERMIT NUMBER
9/8-'06/1.
04*
* 17.00
* 1 7,00 tz
* 17006
*000 0
63
0.9-30-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
.1119j. --):a!-4811'
DATE ISSED
PERMIT NO.
6,4= *17.00R0 -
TOTAL