1982, 10-04 Permit: 82A-9031 WoodstoveAPPLICATION/ 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. �, �;` LEGAL DESCRIPTION — SEE ATTACHED
LOT I ULOCK -ISUBDIVISION PARCEL NUMBER/S
OWNER.f
O E
`0,�-
3.
ADDR SS _
Actual Set Backs in Feet
`i' . �1
North South
East West
CONTRA TO
PHONE
Size of Parcel
Zone Classification
4'
ADDRESS
ZIPType
Const.
Occupancy
Sprinklered
❑Yes [:]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
Area of Decks
Finished Basement
Unfin. Basement
170
6.
TYPE
EW ❑ ALT. ❑A 'N. 1:1 RPL. MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
7, OF El
WORK ❑ BLD. ❑ PLMB. MECH. ❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
of EXEMPTION
DESCRIBIE WORK
Enum. Dist.
Location (Area)
s. a eckl b
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
UTILOITIES
Public ❑Private ❑
Single $
1 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
Building
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of constructions. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
�v — Y -Z
�y _
2—
DATE OF APPLICATION SIGNATURE OF APPLICANT —
ech. 41
SPECIAL APPROVALSI
SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ding T nician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
SEPA
Mobile Home
Other (Specify)
TOTAL $ �7—c)
PERMIT NUMBER
04* *20.00
*2000
A *000
9030ac
10-04-82
z 0479,
WHEN MACHINE VALIDATED IN THISSPACE,
THIS BECOMES A PERMIT.
1"o 04-&2 9.03.125
DATE ISSUED PERMIT NO.
*20.0,0a�
TOTAL
C
C
C
C
G
7