1982, 01-27 Permit: 82A-0665 Wood StovePLP.N 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, /rales
C Li NTC t%i 12 OPP
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWNER
3 D01*V S ttAT F 1 E -LD
PHONE
3s Z-3
ADDRESS
/6/t.1
ZI P
IC/ % ICs
Actual Set Backs in Feet
North 'South East 'Wes
4.
CONTRACTOR
ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
PHONE
ZIP
PHONE
ZIP
TO
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
El OTHER
DESCRIBE WORK
8. Woo c,15-TDY'iE
VALUATI ONSOU RCE
9.
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Size of Parcel Zone Classification
Type Const.
Valuation
Main Floor
Occupancy
Upper Floors
Area of Decks
No. Baths
Sprinklered
❑Yes No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum, Dist.
Storage
Unfin. Basement
No. Rooms
Req'd.
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 r_•ulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION //2-7/82.
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
Plans Examine
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
CC
/O XX
/0 rqt
OC
TOTAL $ 20 XX
PERMIT NUMBER
82 A-- (> 66„ 5'
*2Q00
*20.00
664
0,1-27-82
6479.
• WHEN MACHINE VALIDATED IN THIS SPACE,
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
THIS BECOMES A PERMIT.
'
01q7_82 L L nn
PERMIT NO- Z * 2 'ACV
DATE
la F
DATE ISSUED
FII F (:t1PY