1981, 10-01 Permit: 81B-113 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. C— n4%ds-IgL.00
LOT I BLOCK
2.
OWNER
a &Lisa-A(o PA fZt__
ADDRESS
G . I IC i CAT AL aO
CONTRACTOR
4. SI.n is
SUBDI V ISDN
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
ADDRESS
S Ire
PHONE
Q a4 - l si+
ZIP
CttS(3t C.
PHONE
Actual Set Backs in Feet
North 'South East 'West
Size of Parcel Zone Classification
ZIP
Type Const.
Occupancy - Sprinklered
Dyes DNo D Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
'NEW D ALT. ,D AD N. 0 RPL. 0 MVE.
0 BLD. 0 PLMB. H MECH. 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. 1\3 Ot,b t.r1 ia(:
VALUATION SOURCE
OF
9. UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist.
Location (Area)
Ownership
Public DPrivate 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 9
SIGNATURE OF APPLICANTV6r/��'-d/T>r/ri`s^-� �' `-�`^<7\
SPECIAL APPROVALS
NAME DATE
Env. Healt
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
tli Techt
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 17•
PERMIT NUMBER
5u3 -Ila
04* *1700
*17.00 t
*17.006
A *000 8
11.2
11 �0�01'-81
2 6479.
11
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1:130 *'1.7:10 0,a e
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL