1980, 02-20 Permit: 80-1338 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 4 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK SUBDIVISION PARCEL NUMBER/S
OWNER
3. ) h AP—C,.ti)
ADDRESS
CONTRACTOR
C- 1 `, R
4. ADDRESS
DESIGNER
5' ADDRESS
6. U
CHANGE OF
TYPE Ef POEW
7, OF
WORK ❑ BLD.
PHONE
9 z-1 - ye, 9:3
ZIP
`Y'rj
PHONE
5-41s- Y)
ZIP
PHONE
ZIP
M ITO
❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
' OTHER
ElPLMB. E)MECH: ElM.H. ❑ POO L
Required Set Backs in Feet
North South
East West
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
Dyes [-]No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
DWL Area
Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
Req'd. I
Recd.
Not Re
of EXEMPTION
DE�S,S,$IBE WORK
r FEES COLLECTED
8.
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities Single $
1 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 Building
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. Plumbing
DATE SIGNATURE— Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DAT E&AL--4-00FFICIAI.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
::* M 1
DATE
OC) * * 700
i. no
x7,�1oY
L 0 1 C�,
1 33.7
02-2':0- 0
f 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS _BgCOMFS A PERMIT.
is 0 0
a