1980, 01-22 Permit: 80-442 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
seo 3 S G 1Xk. k i►' A2 2ADflC r'
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
3. (tZ C.\ G► !4 G L.D
ADDRESS
S- 111 13b L.L\i-Arm
CONTRACTOR
4 vvC
ADDRESS
PHONE
C4-2-4-7/65`.3.-
PARCEL
iZ4-16S`3
PARCEL NUMBER/S
ZIP
C;t6i v 3-7
Required Set Backs in Feet
North (South
Eas
DESIGNER
5' ADDRESS
6.
CHANGE OF USE FROM
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
PHONE
ZI P
PHONE
ZIP
TO
❑ AD'N.
MECH:
❑ RPL.
O M.H.
O MVE.
❑ POOL
❑ OTHER
Size of Parcel
Type Const.
Occupancy
Valuation
DWL Area
Split Entry
Basement Area
West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Split Level
Storage
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
W IS VA Lk_
VALUATION
9.
U.%c, o o V£
Source
of
Utilities
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
perform, an of construction.r
DATE/5X�" , a` /.+ i9,; 0
GAS
ELECTRIC
WATER
SEWER
examined this application and have read the "NOTICE" provisions included
to be true and correct. All provisions of laws and ordinances governing this
whether specified herein or not. The granting of a permit does not presume
the provisions of any other state or local law regulating construction or the
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D.
RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
77 8�[(,
DATE 4i2//811 OFFICIAL/Z/1
APPROVED CE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
1,C C'
TOTAL $ 7 CJS
fr1
PERMIT NUMBER
SO - 4-Z.
DATE 1—"Z
04*
*7.00
*7.00 V)
*7.006
E *0.00 8
4 4, 1
01-22-80
2 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS oBECOMESAI PERMIT.
11H 2
4425 *7,00°�