1980, 03-03 Permit: 80-1703 Wood StoveIF -LAN 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
14Zz S. F
LOT
SUBDIVISION
OWNER
3. 0AQYL- So'
PHONE
954,—C(8S6
ADDRESS
14ZZ S. ThC.4F!`
4.
CONTRACTOR
E1L1S wCL4 -NCI
ADDRESS
6.G5Ig Y2.GNr
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
NEW
❑ BLD.
❑ ALT.
❑ PLMB.
ZIP
`1?D6
PHONE
S34 -70g1
ZIP
PHONE
ZIP
TO
❑ AD'N.
ISI MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
8.
DESCRIBE WORK
N T
bad
VALUATION
9.
'RN IN
Source
of
Utilities
Sro G
GAS
ELECTRIC
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North
South East
Size of Parcel
Type Const.
Occupancy
West
Zone Classification
Sprinklered
❑Yes No ❑ Req'd.
Valuation
DWL Area
Basement Area
Split Entry
No. Baths
Building Area in Sq. Ft.
Garage Area
Split Level
CERTIFICATE
of EXEMPTION
WATER
Storage
Rancher
No. Rooms
Req'd.
SEWER
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 authori"' to violate or cancel the provisions of any other local law lating construction or the
performance f c nstruction.
DATE 1�v SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
HOME OWNER'S WARRANTY
YES
NO
SPECIAL CONDITIONS:
_PATE3Pf80 OFFICIAL 96.7.
APPROVED F ISSUANCE
Rec. Room
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
b
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
1.60
TOTAL $ !•oo
PERMIT NUMBER
DATE 3/3/So
04 *7.00
*7,00 o
*10.006
E *300
170,22
03'-03-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'31.703i-80
170,35 *7.000E-