1980, 02-01 Permit: 80-804 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 4 COPIES
JOB ADDRESS
,
LOT GZ D
3ESSiE
LEGAL DESCRIPTION - SEE ATTACHED
BLOCK
2.
SUBDIVISION
PARCEL NUMBER/S
OWNER
3 CLA'6t L . CLuVE
ADDRESS
11.
02r) BEs
CONTRACTOR
4.
PHONE
8243—OGS
ZIP
�t�zrs�
Required Set Backs in Feet
North 'South
East (West
PHONE
Size of Parcel Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy Sprinklered
Oyes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation 1Building Area in Sq. Ft.
ZIP
DWL Area l Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
c NEW
❑ BLD.
❑ ALT.�❑ AD'N. 0 RPL. 0 MVE.
❑ PLMB. ill MECH. 0 M.H. 0 POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. INS -NA \Ai A p STO J €
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
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 s - per it does not presume
to give authority to violate or cancel the provisions of any other state or local a regu a construction or the
performance of construction.
DATE / f^`t 1 — O SIGNATU
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CO 1 ITIONS:
/I S / "JI+-/� V
DATE �/1l V OFFICIAL
APPROVED R ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. —1'°°
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ I`OO
/47
DATE V31/80
PERMIT NUMBER
/-/
*7.00
*7.00
*7.006
E *000
8Q3R
02-01-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
021-01,='8`'0.
80.4z
*7.00 F