1980, 04-21 Permit: 80-3750 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
JOB ADDRESS
1. N, tSzv
LOT
2.
3
\/—) INA Avg.)
LEGAL DESCRIPTION - SEE ATTACHED
BLOCK
SUBDIVISION
4.
WNER
vI0+I1/4)El7 EIZYi
PHONE
PARCEL NUMBER/S
ADDRESS
31::;'winnary
CONTRACTOR
5 4t'ryvtE
AQDRESS
ZIP
a `f Zo (m
Actual Set Backs in Feet
North 'South East 'West
PHONE
Size of Parcel Zone Classification
ZIP
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
q5 NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
I$ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. 1 vis r► _ i3 k� � 4 C
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
Enum. Dist.
ELECTRIC
WATER
SEWER
Ownership
'Location (Area)
USE CODE
Public ❑ Private ❑
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
0- - s ---d SIGNATURE OF APPLICANT o' �°',K96,,,__
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu Technician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. 1`CDC)
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
04* *7.00
*7.00 165
*7.006
E *000
374,92
04-21-80
g 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
00-.2'1M 1J
DATE ISSUED
5.75,02
PERMIT NO.
*7.0.0 2.r!
TOTAL