1980, 09-15 Permit: 80B-0188 Wood Stove(PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
<a APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3•COPIES
JOB
LOTADDRESS DRS
B2OJK I 1DI }'IWN
2.
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
3.
4.
OWNER
C14L' R.
��r1 N
o -ficos/1,-
CD)J .
�
Rq �Ri 7 V✓
5$;035
ZIP
Actual Set Backs in Feet
North 'South [East (West
PHONE
Size of Parcel I Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
OYes DNo 0 Req'd.
5.
DESIGNER
PHONE
Valuation I Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unf in. Basement
Ii0 NEW 0 ALT. ,0 AD N. 0 RPL. 0 MVE.
0 BLD. 0 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.
CIRIBE
8. DESIVO00 RK 1t IIySVI 'I
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
Enum. Dist.
Location (Area)
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 47/4186) SIGNATURE OF APPLICANT JJ )
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marsha
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ng Techni
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single . $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
00
TOTAL $ /
M
PERMIT NUMBER
oi OS
04* *7.00
*7.00 3
*7.006
A -*000
18.72
09-15-80
0,
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'119414,11511481i0$
DATE ISSUED
1,8.8'Z
PERMIT NO.
TOTAL
}
0
U
—J
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