1982, 10-12 Permit: 82A-9409 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
1.
2.
3.
JOB ADDRESS
5 2-1 '7 6(1411\1 FDP
LOT BLOCK SUBDIV SION
LEGALDESCRIPTION - SEE ATTACHED
PARCEL NUMBER/5
OWNER
OWNER O�i HAfcz
Si
7-7.17 c/s \I1IJ
PHONE
92/° —oz4e,1
4.
CONTfjAFTQR, _.
ADDRESS
21P99
SONE
Actual Set Backs In Feet
North 'South
East
'West
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Yes ❑No 0 Req'd.
5.
DESIGNER
PHONE
Valuation lBuilding Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
NEW 0 ALT. 0 A 0 RPL. 0 MVE.
0 BLD. 0 PLMB.H. 0 M.H. 0 POOL
Area of Decks
Finished Basement
Unf in. Basement
0 OTHER
No. Baths
No. Stories
J
No. Rooms
No. of Dwellings
CERTIFICATE
• of EXEMPTION
Req'd.
Recd.
Not Req'd.
8.
9.
DESCRIBED RK
O
VALUATION
V r)
Enum. Dist.
Location (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public OPrivate 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
DATE OF APPLICATION 1(7 —11— 8-9 _ SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS: ��/
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
7
PERMIT NUMBER
8zA-740-
04* *20.00
*2Q006
A *000 E
940.82
10-12-82
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
110 T k`'2'`: `8 2: 9,4.09 Ss *2 a o ,0,:g!; _
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL