1982, 01-07 Permit: 82A-0122 WoodstovePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
L/ APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRES
1. c-, I , I t?ff-*L- LEGAL DESCRIPTION — SEE ATTACHED
LOT BLACK SUBDI ON ) ,&"I PARCEL NUMBER/S i 4 /
2.
❑ALT.L�YAD'N.
,�, �`
1:1 RPL.
1-1 MVE.
No. Baths
OWNER
N1 rpt? C'* LV 1 V�1�
No. Rooms
No. of Dwellings
PHONE
❑ PLMB.
FJ MECH.
3.
DATE OF APPLICATION ,/ SIGNATURE OF APPLICA
Mech.
/
CERTIFICATE
Req'd.
ADDRESSjj�{ ('�}
Not Re ' .
W
WORK
WORK
ZIP /
Actual Set Backs
in Feet Iyr' it
of EXEMPTION
North South
- } i M1
East West
�, e�c��
CO TRA TORy� ,rte/"�}�
I{
VALUATION
PHONE
Size of Parcel
Zone Classification
WATER
SEWER
SE CODE
4.
ADDg�
0�
ZIP
Ty 4onst.
occcu ancy
Sprinklered
�-�� V ���V
[
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation G
'Upper
�a
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main F� r
Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
�{
TYPE 1J NEW
❑ALT.L�YAD'N.
,�, �`
1:1 RPL.
1-1 MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
7,
P BLD.
❑ PLMB.
FJ MECH.
M.H.
ElI-]c
POOL El
DATE OF APPLICATION ,/ SIGNATURE OF APPLICA
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
CERTIFICATE
Req'd.
Red.
Not Re ' .
W
WORK
WORK
of EXEMPTION
DESCRIBE ORK
8. . ilie_rl-
- } i M1
t-�-�
�, e�c��
,
Enum. Dist. Location (Area) FEES COLLECTED
[Ownership
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
SE CODE
9. 1UTILOFITIES 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 construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
f
DATE OF APPLICATION ,/ SIGNATURE OF APPLICA
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE ^) IN �\� , N� � ' A i �X ��
I Env, ealth C'�-C / l r V I
Plan Check
f
,f_ J_ Yt
SEPA
Fire Marshall
Co.,� }} r
274V 1 v.%.
Utilities
Plans Examiner
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Mobile Home
Other (Specify)
'1
TOTAL s4
WHEN MACHINE VALIDATED IN THI
THIS BECOMES A PERMIT.
PERMIT NUMBER
*2_000
*20.00
*20.00
A *000
12,07
;1-07-82
6479.
04* *20,00
*2000
*20,00c
A *0.00
-1 2 `1
'0,1 -07-82
2 6,479,
011► -07`t-82 1'222 *4a0'0x0 -
DATE ISSUED PERMIT NO. TOTAL