1981, 11-03 Permit: 81B-1420 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - D::ILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB A DRESS
{V I A./1 TO
LOT I BLOCK SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
3
PARCEL NUMBER/S
OWNER (Jrf-1 lI s -re <.CI
ADDR SS
h,, i oil
CONTRA TOR
4. ADORES
PHOr.
ZIP
-�99
`)97 -lam
Actual Set Backs in Feet
North !South
East
West
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
!NEW
❑ BLD.
❑ ALT.
❑ PLMB.
PHONE
ZIP
PHONE
ZIP
Size of Parcel Zone Classification
Type Const.
Valuation
Occupancy
Main Floor
TO
❑ AD'N.
0 RPL.
MECH. ❑ M.H.
❑ MVE.
O POOL
0 OTHER
Area of Decks
No. Baths
DESCRIIBE WORK
S
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
Upper Floors
Sprinklered
❑Yes No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basemen
No. Stories
No. Rooms
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
SEWER
Ownership
Public D Private 0
Req'd.
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 APPLICATION 1 \�� SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
•
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Storage
FEES COLLECTED
Single $
Building
Plumbing
L7
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ I l
PtHMI I NUMBhIt
t 42'
04* *17,00
* 1 7.00
* 17006
A *000
141.9R
11-03-81
6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
py 4 4i je'S
DATE ISSUED PERMIT NO. TOTAL
142.05 *17.00?° -
FU F r(1PV