1980, 11-19 Permit: 80B-3971 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
S. c'2 CaAM-C ✓ GST
LOT
BLOCK SUBDIVISION
OWNER PHONE
3 a9UJ/0 kGCSC9ZS/-66/5/
ADDRESS
2YS Cc#vXc.1 -v c7 -
4.
CONTRACTOR
ADDRESS
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
ZIP
03 "7
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
PHONE
ZIP
PHONE
ZIP
TO
NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. E MECH. ❑ M.H. ❑ POOL
❑ OTHER
DESCRIBE WORK
8. 6t-)00ABCr.Prvl/c.2
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Actual Set Backs in Feet
North (South
Size of Parcel
Type Const.
East (West
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Main Floor
Upper Floors
Area of Decks
No. Baths
Building Area in Sq. Ft.
Garage Area
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Storage
Unfin. Basement
No. Rooms
Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
I hereby certify that I have read and examined this application and nave 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 R VERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SPECIAL APPROVALS SP CIAL CONDITIONS:
NAME DATE
Env. Healti-
Planning
Fire Marsha
Co. Engineer
es
clans Examiner
SEPA Checklist
Building T
clinician
rURE OF APPLICANT
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. r 70 C
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 2 00
PERMIT NUMBER
Hca -3et-71
04* *7,00
*7.00
*7,006
A *000 8
397,0
11-19-80
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
111t1,1-13:0, 3,9'7.11 *Z002 r
DATE ISSUED
PERMIT NO. TOTAL