1981, 04-13 Permit: 81A-3440 WoodstovePLAN NUMBER
1///.0/st
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON /,SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3COPIES
1.
2.
3.
JOB ADDRESS
N , G ��
�
-160.1f1A1090 o i -b 2
Lc) -(19 1\!611 AIL
LOT BLOCK SUBDIVISION
OWNER
LEGAL DESCRIPTION — SEE ATTACHED
AD�RESS
CONIC4QR
ADDRESS {���,
-�4 1<eal
PARCELNUMBER/S 02-‘14 3- ZOD1
PHONE
ZIP .,
Actual Set Backs in Feet
North (South
East '(West
PHONE
Size of Parcel Zope Classic tion
lAr,/%['
ZIP
DESIGNER
5• ADDRESS
PHONE
Occupancy'
Valuation Building Area in Sq. Ft.
Ty,peJonst.
Sprinklered
❑Yes 0 N 0 Req'd.
ZIP,
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
DESCR BE WORK
8. kjQOIJ
NEW
IiBLD.
❑ ALT.
❑ PLMB.
D p N. ❑ RPL. ❑ MVE.
L7 MECH. 0 M.H. ❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd..
Not F,q'd.
VALUATION
9.a
- i -'»/r' 4I 1 N
ELECTRIC
SOURCE
OF
UTILITIES
GAS
41I141VYYi
Enum. Dist. I Location (Area)
WATER
, SEWER
Ownership � zUSE CODE
Public 0 Private L`7
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
//8
SIGNATURE OF APPLICANT
/..,/��/,-//,:�
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer.
Utilities
Plans Examiner
SEPA Checklist
` i•-
;`nician
i
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
• FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
10
PERMIT NUMBER
�ch7,446)
-
s
0'2* *1 Q;,d.d
* 1.0,00
3'43'8 R
04.-13-8:1
2 6.479..
04*
*.1,7: 0;0
3'4.3.94
0'4- 1 3-8u1
2 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. •
DATE14 SUEL., ��