1980, 12-24 Permit: 80B-5223 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 �//66T BLOCK VISer1442
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
NER Jn'
pC l RC1
,-...DRESS
1�/J 1469 A9Le _fi d ,�,e4- c2
CO TRACTOR 1
t -i2 _
ADRESSp RESS
.IdMA P
DESIGNER
6. ADDRESS
PHONE
926-U87 7
ZIP
992_4)6
Actual Set Backs in Feet
North (South
East
(West
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Dyes EINo ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Garage Area
Upper Floors
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
MEC H.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Roorns
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd-
Recd.
Not Req'd.
DESCRIBE WCa RK
8. ,7i7Lee
VALUATION
9.
ti.,,c aL&. 0*,
Enum. Dist.
Location (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 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 .
SIGNATURE OF APPLICANy
DATE OF APPLICATION /2— a -4-r&
' SPECIAL APPROVALS
NAME DATE
Env. Health
anning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
BuildingWluno
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
S7
TOTAL
PERMIT NUMBER
STD —52-23
04*
*7.00
*700
5222@
12-24-8.0
a 6479.
1.
411
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
5!2:23.
PERMIT NO.
TOTAL.
0.
n
C
LL
LL