1980, 11-04 Permit: 80B-3147 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
Occupancy
Sprinklered
LEGAL DESCRIPTION — SEE ATTACHED
1. .5513
R .
❑Yes ❑No ❑ Req'd.
LOT
BLOCK
Valuation
Building Area in Sq. Ft.
PARCEL NUMBER/S
2.
I
ISUBDIVISION
ADDRESS
ZIP
OWNER
PHONE
Garage Area
SCf1tACT
3. -57e�'6
Co6ZZ
ADDRESS
TO
ZIP
Actual Set Backs in Feet
—,C-. -�3/pj
6.
970/ig
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4' ADDRESS
ZIP
Type Co7tj
Occupancy
Sprinklered
DATE ISSUED
PERMIT NO.
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor I Upper
Floors
Garage Area
I Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
TYPE El NEW El ALT. 11AD'N. El RPL. 1:1MVE.
7• OF _/ ❑OTHER
E3BLD. ElPLMB. 00 MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Reqd.
'
Red.
c
Not Req'd
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
8• 1C%G9c%.OB'VRN/
S'l� r✓C
VALUATION
SOURCE
GAS
WATER
SEWER
Ownership
USE CODE
9.
OF
UTILITIES
17ELECTRIC
Public ❑ Private ❑
Single $
I 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 SIDE FOR REQUIRED INSPECTIONS
Plumbing
/�REVERSE
M
#21—c—�
DATE OF APPLICATION / / " a ` SIGNATURE OF APPLICANT
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
Plans Examiner
SEPA Checklist
Buil in echnici
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
TOTAL $ % E�
M IPERMIT NUMBER
8O R - 3i 47
(;4* 70
0 0Y
r
146
11-04- 0
6,47;
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
,111-i-It8 D.,.,
DATE ISSUED
PERMIT NO.
*7.00'a0j, -
TOTAL