1981, 04-09 Permit: 81A-3343 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORjH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3•COPIES
1.
2.
JOB ADDRESS
isa7
LO BL•
at.e.votoi.,/
LEGAL DESCRIPTION — SEE ATTACHED
OWN^'' Xlp teat
2 /7
CO TRACTOR
4 442444.-e
ADDRESS
PHONE
viz& --i91.3
ZIP
PHONE
.2.
PARCEL NUMBER/S
Actual Set Backs in Feet
North . South East We
Size of Parcel Zone Classification
ZIP
Type Con
Occupancy Sprinklered
Oyes ONo - O Req'd.
5.
DESIGNER
PHONE
Valuation Building Area In Sq. Ft
ADDRESS
ZIP
Main Floo
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Un f in. Basemen
TYPE
7. OF
WORK
O NEW 0 ALT. O AD N. 0 RPL. O MVE.
O BLD. 0 PLMB. "' MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Storle
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WO K
VALUATION
9.
SOURCE
� S ,1. ELECT
SOVRCE GAS I ELECTRIC
OF
UTILITIES
Enum. Dist. I Location (Area)
WATER
SEWER
Ownership
Public O Private O
USE CODE
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
to give authority to violate or cancel the provisions of any other state or local law regulating construction oor e
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION— 9 —1(1
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Eng nee
Utilitie
Plans Examiner
SEPA Check
Itlingrahni ir
ir a,Pf.
SPECIAL CONDITIONS:
Sptia,obeita
/(,/R.{D.C.&�-��=',/(Gy�bf,ld�.7g���L /astir
li/
DK 4 3, . 'nada Cbat,/ e(
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing ��y(
Mech. / 7
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 1 %
PERMIT NUMBER
sr/A-
.04* • *17.00
*17.00 5
33422
,p4-09-8.1
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0,4jrIO!41_� 1;
DATE ISSUED PERMIT NO. TOTAL '
33:4,)1 *1'7.00a-12
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