1980, 10-09 Permit: 80B-1737 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 ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWNER
604./,4-440 Atf44cade
ADDRESS
PHONE
ceoo�3
ZIP
CONTRACTOR
4' ADDRESS
PHONE
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
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
L7/ NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
0 BLD. ❑ PLMB. l_I/MECH. 0 M.H. 0 POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. WkloOl9Gf,/Ul,4) C, �7re JE
Enum. Dist. I Location (Area)
9.
VALUATION SOURCE
OF
UTI LITI ES
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 + permit does not presume
to give authority to violate or cancel the provisions of any other state or local la �� lating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION
SIGNATURE OF APPLICA
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
ti
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
BWltlin• : chnIclan
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing �7
Mech. L ` �,
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ 7, Ina.
11
PERMIT NUMBER
fro+ t7T3'/
04* *7.00
*7.00 V
*7.006
A *000 F,
17362
10-09-80
Q 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
01,4{).(P -N8; 0'
DATE ISSUED
1.73,7Q
PERMIT NO.
*7.00°
TOTAL