1982, 09-28 Permit: 82A-8819 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 3 COPIES
JOB ADDRESS
1. 0. LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCKjSU-BURr1-9F59--PARCEL NUMBER/S
2. 1f�) 4 9M ISStvv i Aon .
OWNER
PHONE
3. -� s •��u*. 'r- il% -,
A - -5\
1i5dr-2
ADDRESS
ZIP
Actual Set Backs in Feet
*W. kZ.N a V#cn,
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
C -J PkYN.-
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Dyes ❑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.
TYPEEW ❑ ALT. ❑ AWN. 1:1 RPL. El MVE.
J
No. Baths
No. Stories
No. Rooms
No. of Dwelling!
7, OF ./ 1:1 OTHER
1:1PLMB.
Req'd.
Recd.
Not Req'd.
WORK LI BLD. MECH. ❑ M.H. ❑ POOL
CERTIFICATE
I
of EXEMPTION
DESCRIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC WATER
SEWER
Ownership
9.
OF
UTILITIES
Public ❑ Private ❑Single
$
1 hereby certify that I have read and examined this application and have read the
"NOTICE" provisi
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances gotype
of work will be complied with whether specified herein or not. The granti
Inuded
of a ermit does
Building
to give authority to violate or cancel the provisions of any other state or local la
re u ing constru
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
S
Plumbing
4�^SrZ—
Z0•00
DATE OF APPLICATIOfS f `` SIGNATURE OF APPLICAN
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
n PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
PERMIT NUMBER
E5'Z.A-881�'f
U2* *2000
0 11
*40.00 n
*40.00
A
09-2F-32
6.479.
SEPA
C
Mobile Home
i
Other (Specify)
TOTAL $ AQ• DO
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
881,92
DATE ISSUED PERMIT NO.
*4a00R0 -
TOTAL