1981, 12-11 Permit: 81B-2652 Wood StovePERMIT NUMBER
113-2652-
,04 *
24 52-
PLAN NUMBER
t /t
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
1. - IC )126 P1 Yv
W/11
LOT II
2. '—
OWNER
ACKRE 5
l o I 'f' -42M91' 1/1-1
3
BLOCK
EC
SUBDIVISION
/'Ip42(LIJ I
Ti
DESCRIPTION — SEE ATTACHED
Z
U6
PARCELNUMBER/S (2I5
Actual Set Backs in Feet
North 'South
East
'West
CO .1-RACTOR
tvM���
4. ADDRESS 733 ",.Itett
V '
PHONE
5 - si
Size Of Parcel
Zone Classification
ZIP
c79
IPte79)
—z%3
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
TO
❑ ALT. 0,0 N. 0 RPL. 0 MVE.
❑ PLMB. /11 MECH. 0 M.H. 0 POOL
0 OTHER
Area of Decks
No. Baths
Finished Basement
No. Stories
No. Rooms
Unf in. Basement
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Re
Not Req'd.
8.
9.
DESCRI 4E WORK
1\1000 51 /6
VALUATION
Enum. Dist.
Location (Area)
SOURCE GAS
OF
UTILITIES
ELECTRIC
WATER
SEWER
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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION/�D SIGNATURE OF APPLICANT'
SPECIAL APPRLVALS SPECIAL CONDITIONS:
NAME —DATE
Env. Health
Planting
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
�.� 22�r1nt4
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
17
TOTAL $
Il
,04* *•17:00
* 1700 b5
* 17006
A *000
2165.1:g.
2•—i1 1 —S 1
64.79.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1;2,;:;1'1' a8
DATE ISSUED PERMIT NO. • TOTAL
2165.2'g It17'0,0'at -