HomeMy WebLinkAbout1980, 01-09 Permit: 80A-9949 Wood Stove1
PLAN 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
J2 ADDRESS
•
LOT BLOCK
OWNER
�\7
3 iu 2,
ADDRESS
SUBDIVISION
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
ZIP
4.
CONTRACTOR
ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
PHONE
ZIP
PHONE
ZIP
TO
❑ AD'N.
MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
Required Set Backs in Feet
North South East 'West
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
DWL Area
Building Area in Sq. Ft.
Basement Area Garage Area
Split Entry
No. Baths
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
Storage
Rancher
No. Rooms
Req'd.
Rec. Room
Rec'd.
Not
Req'd.
DSCRIBE WORK
VALUATION
9.
Source
of
Utilities
GAS
E bECTRIC
WATER
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 authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.
DATE -9 -
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
LSEPA Checklist
SPECIAL CONDITIONS:
1
DATE/ OFFICIALJltlia (/
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
DATE ,i —'7_ 8'e)
04* *7.00
*7,00
*7.008
E *0.00
994,82
01-09-80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
01-09'-50 99492
*7;00°