1980, 10-08 Permit: M80B-1620 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. .
LOT BLOCK SUBD VISION
2.
LEGAL DESCRIPTION - SEE ATTACHED
3
OWNE
;?
NE
'aO�- 0/6.2.--
PARCEL NUMBER'S
ADORES
t'/SS/S- . ¢
Z!99ao�
Actual Set Backs in Fee
North
South
East 'West
CONTRACTOR
4 LUe /e..c. 2 Me eind1
ADDRESS
4/ o 8/5 /vrsro/T
PHONE
«d /0/ 7
ZIP
99.wr
Size of Parcel
Type Const.
Zone Classification
Occupancy Sprinkle ed
Dyes ONo 0 Req'tl.
DESIGNER
6. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Deck
Finished Basemen
Unf In. Basemen
TYPE
7. OF
WORK
0 NEW 0 ALT. 0AD N. 0 RPL. 0 MVE.
❑ BLD. 0 PLMB. RS�ECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings •
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.L/iSK-CC2i A/SMIE.C� L fOodS4171_
Enum. Dist.
Location (Area)
VALUATION SOLRCE GAS ELECTRIC WATER
OF
9. UTILITIES
SEWER
Ownership
Public 0 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
/04/o
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utllitie
Plans Examiner
SEPA Checklis
---Bljiltli ng Tec ian e
SPECIAL CONDITIONS: •
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing r
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
80 -Ve2.0
04* *7.00
*7.00 U5
*7.006
A *Q00
161.92
1,0-08-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
1''6 2;0 9
PERMIT NO.
'*7.Q0
TOTAL