1980, 11-10 Permit: 80B-3529 Wood StovePLAN NUMBER
P/
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3676
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. E /9/ 73cossc V
LEGAL DESCRIPTION - SEE ATTACHED
2.
3
LOT
BLOCK
SUBDIVISION
OWNER
/Q0 ae-- T C. • () 425
PHONE
9—7g2z
PARCEL NUMBER/S
ADDRESS
• /24.67<, 8c4:550Ev
ZIP
990/C
Actual Set Backs In Feet
North (South East 'West
4.
5.
CONTRACTOR
PHONE
Size of Parcel Zone Classification
ADDRESS
5.09/Its-
DESIGNER /.9/!2E
DESIGNER
ZIP
Type Const.
Occupancy Sprinklered
❑Yes ❑No 0 Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ NEW 0 ALT. 0 AD'N. 0 RPL- ❑ MVE.
M.-MECH.
/ 0 OTHER
❑ BLD. ❑ PLMB. M MECH. ❑ M.H. ❑ POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. C.---)0+� 3U2rf iAv UE
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE GAS
OF
UTILITIES
ELECTRIC
WATER
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 APPLICATION
SPECIAS. APPROVAL
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Build' • Technician
f/ /C!
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
n
PERMIT NUMBER
04* *7.00
*7,00
*7.006
A *000 0
35288
11-10-80
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
,' 1 t L,0
DATE ISSUED
.80.
3'529 g
PERMIT NO.
TOTAL