1980, 06-09 Permit: M80-5529 Wood Stove, ChimneyPLAN 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
c t51:,6\PLAW
LEGAL DESCRIPTION - SEE ATTACHED
LOT
LOCK SUBD VISION
k\ 7 tJL] F7(itJ •
OWNER I� PHONE
3. l 1(k k7 � N 4 ,-4953
ADDR SS
47,07 - F 7706
CONI43.1 C/
4.
ADDRESS
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
aS NEW
❑ BLD.
❑ ALT.
❑ PLMB.
PHONE
ZIP
PHONE
ZIP
TO
❑ AD'N.
*S- MECH.
❑ RPL.
❑ M.H.
8. DESC_ F�IBOE WORK rok,4 I *j
VALUATION
9.
SOURCE
OF
UTILITIES
GAS I
❑ MVE.
❑ POOL
❑ OTHER
PARCEL NUMBER/S ` v62-`7
� ^ 7
N(< 701 or Lig-'F%
�/I ��
Actual Set Backs in Feet
North (South [East (West
Size of Parcel
Type Const.
Occupancy
Valuation
Main Floor
No. Baths
ELECTRIC
WATER
SEWER
En
Upper Floors
Zone Classification
Sprinklered
❑Yes No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area Storage
Unfin. Basement
CERTIFICATE
of EXEMPTION
um. Dist. I Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
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 APPLICATIONSIGNATURE OF APPLICANT
SPECIAL APPROLS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu ding Tpchfl cian
SPECIAL CONDITIONS: l/
j-►I.11iJ f() 16 �I r "M lei II
4,150 -01'6 .or A N1 I I,cA G+ i M O l
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
FEES COLLECTED
Single $
Building
Plumbing
Mech. ! � 0o
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
,c`)
04*
*7,00
*7.00
55282
06-09-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
"06'4,-10'9• -U3
DATE ISSUED
5'5292 *7.002', -
PERMIT NO. TOTAL