1981, 09-23 Permit: 81A-9722 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
N 3��
�[y
LEC�,AL.DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWNER
3. • • L. c.›-
PHONE
ADDRESS
1\)
CONTRACTOR .
4.
- ADDRESS
Sa►m`.
ZIP
Actual Set Backs in Feet
North 'South.
East
(West
PHONE
Size of Parcel
Zone Classification
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'
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
L•1 NEW
0 BLD.
❑ ALT. 0 AD'N.
❑ PLMB. L7 MECH.
❑ RPL. 0 MVE.
0 OTHER
❑ M.H. 0 POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBEWORK
8. 1i 1. 'rai2.n3 I A S Szry::: c?:
SOURCE GA ELECTRIC
OF
U
VALUATION S
9. - TILITIES
Enum. Dist.
Location (Area)
WATER
SEWER
Ownership
Public 0 Private ❑
USE CODE
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 compliedwith 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 - •.lating construction or the
performance of construction. E RE)1/ERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION
02)
SPECIAL, APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SIGNATURE OF APPLICANT
,PECIAL CONDITIONS:
4
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
• Mech. .CO
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 17'Ott
PERMIT NUMBER
llIP -��rl�Z
04* * 1 7.00
A
9,72i1 2
'0.9-23-81
_z_ 6479.
*000 8
0
O
U
uJ
J
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
i
9722 Z *I7 O a'
NO. TOTAL
PERM'