1980, 12-04 Permit: M80B-4435 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. E t� ' G`3 t3' c,cC;LEYE
LEGAL DESCRIPTION — SEE ATTACHED
2.
3.
LOT
BLOCK SUBDIVISION
PARCEL NUMBER/S
5.
OWNER
ADDRESS
CONTRACTOR
5 rP-C,Kd-a/V6
ADDRESS
DESIGNER
PHONE
Gc�4q ick
ZIP
RCA_ icy v�
Actual Set Backs in Feet
North South
East
West
F1 r2 pc oC
PHONE
4e'3 -- tot -7
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Oyes ❑No ❑ Req'd.
PHONE
Valuation 1 Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
LI NEW ❑ ALT.
❑ BLD. ❑ PLMB.
❑{ AD'N.
CJ MECH.
O RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
VALUATIONSOURCE I GAS
OF
9. UTILITIES
Enum. Dist.
Location (Area)
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private 0
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
dC4C..A..SIGNATURE OF APPLICAN %�""e`"'t
DATE OF APPLICATION
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
nv. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Id
ng Technician
/2../y a
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 7. Od
PERMIT NUMBER
PC:ii3— 4(7135-
04* *7.00
*7,00
*7.00
A *0.00
44342
12.04-80
2 64.79.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12 — O, 4,;-.8
DATE ISSUED
443.52
PERMIT NO.
*Z0.0?I:j -
TOTAL