1980, 01-24 Permit: 80-517 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 4 COPIES
1. JJq� ADDRESS
2//7
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
UBDI VISION
3.
OWN84111144-24;v
i( -y/a./
DD ESS
4 7 (1.4t z-fsJ 1/14 11.01.0
CONTRACTOR)
4. BC./d7w.e/_
ADDRESS
7>(1QQ/( /Ate --
DESIGNER
5.
PHONE
924—/9/y .
ZIP
9x0.37
PH NE
PARCEL NUMBER/5
ZIP
PHONE
ADDRESS
ZIP
Required Set Backs in Feet
North 'South East (West
Size of Parcel Zone Classification
Type Const. Occupancy Sprinklered
❑Ves 0No 0 Req'd.
Valuation Building Area in Sq. Ft.
DWL Area I Basement Area Garage Area Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
0 NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
❑ BLD. 0 PLMB. X MECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd. •
Re 'd.
Not Req'd.
DE
SCRIIBE WORK
$.VALVA/Ai } Source 1-W4-141;14 ^�ELECTRIC
�
of
9. Utilities
GAS
WATER
SEWER
I hereby certify that I have read and examined this applica ion and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correc . All provisions of laws and ordinances governing this
type of work wfll 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 /—.2./3 KJ SIGNATURE ' 4/70 MJ 4tL'
DEPT.
SPECIAL APPROVALS
REO'D. RECD.
Env. Health
Planning
S Fire Marshall
Co. Engineer
. Utilities
Zone Clearance
SEPA Checklist
•
SPECIAL CONDITIONS: - -
DATE2J—O ✓) OFFICIA Lt II.tZQ/
FEES COLLECTED
Single $
Building
Plumbing
Mech. 79 .7 D6
Plan Check
SEPA
Mobile Home
Other (Specify)
/�,
TOTAL
1
PERMIT NUMBER
RD --5/7
DATE / -1 1-R0
04* * 7:0,0
*7:00 t
51.6A
01 —24'-80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•
5 17 Z *'7.0'0; a�
APPROVED FOR ISSUANCE _
0
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