1980, 11-12 Permit: 80B-3576 WoodstovePLAN NUMBER
w
Mi f
0/
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
1cOT/ /�
2.
O
4.
5.
6.
LEGAL DESCRIPTION - SEE ATTACHED
NER
,e/1-41, 1
AbDRBbS
CO TRACTOR
PHONE
97x7
ZIP
PHONE
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South East (West
Size of Parcel 1 Zone Classification
ADDg9RESS
DESIGNER
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
PHONE
Valuation (Building Area in Sq. Ft.
ADDRESS
CHANGt OF USE FROM
ZIP
Main Floor
Upper Floors I Garage Area
Storage
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
0 OTHER
❑ BLD. 0 PLMB. MECH. 0 M.H. 0 POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.S,
VALUATIO
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC 1 WATER 1 SEWER
Enum. Dist.
Location (Area)
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 INSPECTION
DATE OF APPLICATION %/ 21%j
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
BtAding
�Tec ician
SIGNATURE OF APPLICANT
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 $
PERMIT NUMBER
G
04*
*7.00
*700
357,5g.
11-12-80
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11+12 BD 3,57.6g *Z002.0 —
DATE ISSUED PERMIT NO. TOTAL