1980, 02-13 Permit: 80-1107 Wood StoveJ
PLAN NUMBER
Diet4- 7'-F-y2.2?c`.__a.Ili(
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
X18A7OBE$59 .Rurr?gCup Spokrl-iue;Lill
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3.
OW ER
rnAc. c. I4J, LLI14-rns
4E -0Y-71
PARCEL NUMBER/S
ADDfSSI. 9-07 Bu/!e4I P
•zul f St:0169.0 L Ii'4Z e -/OV(.
4. lCTL3c47v,077S- r, e6,777 a/ N:/
&3S
ZIP
,_, t- /.Ey/ee/C_ sta, 9°2207
DE IGNER
5c4f ? 1)E -c 5. -to vC AJD�J
5.a • re -/4/ rAII)ci cx
Required Set Backs In Feet
North 'South East IWest
Size of Parcel - • 1 Zone Classification
Type Const.
Occupancy
Sprinklererl
❑Ves ❑No ❑ Req'd.
P4D 9_S6r2
45-0 9
Valuation 1 Building Area in Sq. Ft.
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE NEW
7. OF
WORK 0 BLD.
❑ ALT. 0 AD N. 0 RPL. 0 MVE.
❑ PLMB. 0 MECH. 0 M.H. 0 POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
8.
9.
DESCRIBE WORK •
.. irG ST -A I -L WOOD Stove ... Fr ek: PLAosz
VALUATION
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
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.
DATE
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zane Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATER -1 1. C1 OFPyCI AL
APPROVED FOR ISSUANCE
16.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
c o_ iID-1
04* *7.00
*7.00
*7.006
E *Q00 8
110.6E
02-1380
6479.
—
U
w
a
z
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
02' 1131-8.01. 11a7z kzo'oa