1980, 12-09 Permit: 80B-4642 WoodstovePLAN 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
JOB ADDRESS
, ee.7f.O 7 •iso -=-q•, P\Oi\
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3.
OWNFxRI Jv`�� '"� , .-(V
PHONE
PARCEL NUMBER/S
ADD F)- ESS
�5o7 i -r-o.1 K4T(2
CONTRACT R
PHONE
Actual Set Backs in Feet
North (South East (West
Size of Parcel I Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
DESIGNER
5• . ADDRESS'
PHONE
Valuation (Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
�E W
0 BLD.
❑ ALT. 0,�, ��AD'N. ❑ RPL. ❑ MVE.
❑ PLMB. LrJ-'MECH. 0 M.H. 0 POOL
❑ OTHER
No. Baths •
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK'
8.V•VI
Enum. Dist.
ILocation (Area)
VALUATION
9.
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
DATE OF APPLICATION /Y' ^ ' �> �/ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE .
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
• FEES COLLECTED
Single $
Building
Plumbing
DJ
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
00g- 4-621-
04*.
*100
*7.00 17)
464.12
12-09-80
z 647'9,
WHEN, MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'12':a,6,;9,,1'$101
DATE ISSUED PERMIT NO. TOTAL
46,4::2,2 *7:00 O.