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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