1980, 11-06 Permit: 80B-3308 Wood StovePLAN 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
LOT
2.
B 4'Ja,Divlsloa�a
fin.
LEGAL DESCRIPTION - SEE ATTACHED
3
4.
5.
OWNER
7A/✓
ADDRESS
ae/2/ Ti
PHONE
928-9696
PARCEL NUMBER/S
5. c/3 2/ afie R0.
ZIP
99e0C
Actual Set Backs in Feet
North 'South East (West
CONTRACTOR
PHONE
Size of Parcel Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ NEW . 0 ALT. 0AD N. ❑ RPL. 0 MVE.
IJt/
❑ BLD. ❑ PLMB. MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK -
8. 2j00r215CJ e/Meu���yyy S`Tovs
VALUATION' SOURCE 'I GAS -
II OF
9. UTILITIES
Enum. Dist.
Location (Area)
ELECTRIC
WATER
SEWER
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 INSPECTIO
DATE OF APPLICATION WOO 5 /r 10 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marsha
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B(uu diq Technician
Y• le/SI e
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check -
SEPA
Mobile Home
Other (Specify)
TOTAL $ 7.Od
PERMIT NUMBER
803 -33)8
04'* *7.00
*7.00
*7.006
A *0.Q0 S
313_Q72
11=06-80
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
',11„ �0 6; -c'8,;0'
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
3i3'a8Lis . of7.00°a0,.-
PERMIT NO. TOTAL
J-
0_
O
U
-J
W