1980, 05-21 Permit: 80-2520 WoodstovePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK
8.
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities
I 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
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.
DATE STD SIGNATURE_
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS: .-� OK
3-�I-BU
DATE
FEES COLLECTED
Single
$
APPLICANT:
COMPLETE NUMBERED SPACES -
PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
� Dd
Mech.
LEGAL DESCRIPTION - SEE ATTACHED
1.
22
SEPA
Mobile Hol- ie
LOT
BLOCK15'JBDIV15ION
7�
TOTAL
PARCEL NUMBER/S
2.
I
OWNER
PHONE
3.
2 3
ADD ESS
ZIP
Required Set Backs in Feet
mon
Cf;W47
North South East West
TRAC OR
_
PHONE
Size of Parcel
Zone Classification
63,5-17,-ZIq
4.
---[-'
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
"-Z
I
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
No. Baths
No.
Floors
No. Rooms
Rec. Room
TYPE NEW
1:1 ALT.
ElAD'N. 11 RPL. 1-1MVE.
7,
OF
El OTHER
❑ BLD.
ElPLMB.
g MECH: 1:1M.H. E3 POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
8.
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities
I 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
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.
DATE STD SIGNATURE_
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS: .-� OK
3-�I-BU
DATE
FEES COLLECTED
Single
$
Building
Plumbing
� Dd
Mech.
Plan Check
SEPA
Mobile Hol- ie
Other (Specify)
7�
TOTAL
//►'� //q THIS B�COMES A PERMIT.
_ OFFICIA
A DDDniIr" 17nn ' 2QI IA I t'C
PERMIT NUMBER
U— ")-S
DATE
L 11 I.
,
c470