1980, 04-17 Permit: 80-3633 WoodstovePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
1. 4,
LOT BL CF
2 OWNER
3..e4U�XA
ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
LEGAL DESCRIPTION — SEE ATTACHED
SUBIDIVISION
a PARCEL NUMBER/S ,7
r 7 43kf; .Z
PHONE dt
46 b9 Hr ranisr.4res b
ZIP Actual Set Backs in Feet
vqz/ 7
Q North South East West
CO TRACTOR
PHONE
Size of Parcel
Zone Classification
4.
A DRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
Baths
No. Stories
No. Rooms
No. of Dwellings
TYPENo.
❑ NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
❑ BLD. ❑ PLMB. D4 MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
Enum. Dist.
Location (Area)
8
I
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWERUSE
Ownership CODE
9.
O
UTI F
ITIES
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
4 jj
DATE OF APPLICATION _CSIGNATURE OF APPLICANT CaF�>,..Y
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B,wilding Tgfhnic)tn a PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL Q
_
PERMIT NUMBER
04* *7.00
X7.00 v,
363,29
04-17-8,0
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 i4 -17'1- � 0 3' 6 3.3 z
* 7, O U lX M- -