1981, 08-06 Permit: 81A-7854 WoodstoveLAN 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
505 � � LEGAL DESCRIPTION —SEE ATTACHED
LOT I BLOCK UBDI ISIO PARCEL NUMBER/S
OWNERL ` j I �� PHONE
ADD ES �7P�}� Actual Set Backs in Feet
North South East West
CONTRACTOR PHONE Size of Parcel Zone Classification
ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes []No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
TYPE No. Baths No. Stories No. Rooms No. of Dwellings
LB'NEW ❑ ALT. ❑ AD'. -N. ❑ RPL. ❑ MVE.
OF ,—,/�' E] OTHER
WORK ❑ BLD. ❑ PLMB, 2 MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCjIBE WORK Enum. Dist. Location (Area)
OC��, / FEES COLLECTED
VALUATION I SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
UTILOITIES Public ❑ Private ❑ Single $
hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
In reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
ype of work will be complied with whether specified herein or not. The granting of a permit does not presume
o give authority to violate or cancel the provisions of any other state or local law regulating construction or the
lerformance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
)ATE OF APPLICATION44, /� l SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
:nv. Health
'fanning
=ire Marshall
:o. Engineer
Jtilities
ns Examiner
i I I _----
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Mech.
Plan Check
SEPA
PERMITN MBER
785.3
-C6-r?1
6479
Mobile Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
O,18 0& 8''11 785,42
*17.00aij-
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