1980, 10-10 Permit: 80B-1796 Wood StovePLAN 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
1. 5:8/9 Ito c� Po.
LOT S B (VISION
2.
BUCK
LEGAL DL"•SCRIPTION - SEE ATTACHED
OWNER
QeoieGc Soll07Jx65
PHONE
9e&, -976g
PARCEL NUMBER'S
ADDRESS
s.814 !Roue Po.
ZIP
99ze,C
Actual Set Backs in Feet
North 'South [East (West
4.
5.
CONTRACTOR
S;frd,
ADDRESS
On/VLF
DESIGNER
PHONE
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes DNo 0 Req'd.
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
Untie. Basement
NJ NEW 0 ALT. 0AD N. 0 RPL. 0 MVE.
,/
❑ BLD. 0 PLMB. Nl MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'o.
Recd.
Not Req'd.
DESCRIBE WORK
8. ./4Jo.70$u2✓ m
VALUATION
9.
.5 -you e
Enum. Dist. I Location (Area)
SOURCE
OF
UTILITIES
.GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
I hereby certify that 1 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 INSPECTI'NS
LIF
DATE OF APPLICATION /t) '/ 0— filD SIGNATURE OF APPLICAN I Q%lQc�
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bullidn Technician
94 seJanJ
l0//%
SPECIAL CONDITIONS:
FEES COLLECTED
Single $
Building
Plumbing ,/rye
Mech. r/ •7
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$7_er,
M
PERMIT NUMBER
E30- 1?ctro
'04* *7'.00
*7.00 '6
*7.006
A *0.00 3
179.52
10=10-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE • 11101E00 !t V.01 11`7.9.6 g
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
'*7,000.1- -