1980, 09-18 Permit: 80B-415 WoodstovePLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT �i�f 511/V 3 - /,5"
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCKI-SUBDIVISIONPARCEL NUMBER/S
2.
OWNER, PHONE
3. —a1
ADDRESS
ZIP
Actual Set Backs in Feet
f5 /
North South East West
C NTRACTOR
PHONE
Size of Parcel
Zone Classification
4.
AD RESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
TYPE❑ NEW ❑ ALT. ❑ AD' N. ❑RPL. ❑ MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
7, OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. V MECH. ❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
I Recd.
Not Req'd
of EXEMPTION
ESCRIBE ORK
Enum. Dist.
Location (Area)
8
I
FEES COLLECTED
V LU ON
SOURCE
GAS
ELE TRIC WA ER
SEWER
Ownership
USE CODE
9.
OF
UTILITIES
I
i
Public ❑Private ❑
Single $
1 hereby certify that 1 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
% Da
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Building
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
Plumbing
DATE OF APPLICATION% 7'__ __ SIGNATURE OE APPI (CANTK.0 11!1!1 �(i-t(
Mech.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
c cla nj1j PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
02* *17.00
A 1 7 0
* 1 7.00
l'Y
A *.00 S
09-18-80
6479.
TOTAL $ /
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
9�1`-11• _ 81 0 41, 5 z
DATE ISSUED PERMIT NO.
17.00°P
TOTAL
a
C
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