1980, 11-18 Permit: 80B-3889 Wood StovePLAN NUMBER
APPLICATlN/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
1. W NL `T `k
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVIS1O
3.
OWNER4s 14AN1qI
ADDRESS
134o0-7 6 . NAI NJ
PHONE
927 I
PARCEL NUMBER/5
Actual Set Backs in Feet
North (South East 'West
CON C'
4' ADDRESS
PHONE
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
DESIGNER
5, ADDRESS
PHONE
Valuation 1Building Area in Sq. Ft.
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
ISS NEW 0 ALT.❑AD'N. 0 RPL. 0 MVE.
❑ BLD. ❑ PLM8. 12/MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. kOC 9 r�CN
Enum. Dist. I Location (Area)
VALUATION
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private ❑
USE CODE
9.
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 . aw re.. ating con ru ion o he
performance of construction. SEE REVERSE SIDE FOR REQUIRED
DATE OF APPLICATION /!— ! �i ,r V SIGNATURE OF A
SPECIAL APPROVALS
'NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Pians Examiner
SEPA Checklist
SPECIAL CONDITIONS:
//// 9/ sv
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 $
PERMIT NUMBER
c?• -3809
04* *7.00
*7.00
*7006
A *0.00
388.8e
11-18-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•
.11, 18., 8101 313 g. *7.'002PI -
DATE ISSUED PERMIT NO. TOTAL