1980, 10-15 Permit: 80B2071 Wood StovePLAN NUMBER
0i
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
1. E, /3916 #E et> j/
LOT BLOCK SUBDIVISION
2.
.LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
, OWNER
3- c e v E 4/, s2c72WE
ADDRESS
6. /3c.//6 HeRoy
CONTRACTOR
Sig MC
4' ADDRESS
PHONE
x/38-934 /
ZIP
Actual Set Backs in Feet
North (South [East 'West
PHONE
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy Sprinklered
Dyes DNo D Req'd.
5.
DESIGNER
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
. Area of Decks
Finished Basement
Unfin. Basement
D NEW
D BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
g MECH.
❑ RPL.
❑ M.H.
❑ MVE.
D POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. £O34af1!/U
VALUATION
9.
Enum. Dist.
5to tie
Location (Area)
SOURCE
OF '
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
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 or the
performance of construction. -SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION AO /S ?O SIGNATURE OF APPLICA
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marsha
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
gib C
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
4'7..Oo
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 7 oa
PERMIT NUMBER
073^2011
04*
A
207.02
10-15-80
6479,
*7.00
*7.00 1
*7.0.06
*Q00 S.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
ikfral'S!'�1' 2'`ORLz * 00,a1F –
DATE ISSUED PERMIT NO. TOTAL