1981, 09-25 Permit: 81A-9844 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PUSS HARD TO MAKE 3•COPIES
1.
2.
3.
4.
5.
JOB ADDRESS
5,
LOT
OWNER •
sat L.ti
ADDRESS
.
CONTRACTOR
1
BLOCK
7RrMF.
ADDRESS
SA wit
DESIGNER
If1,7 3 L—P ceIz�.
LEGAL DESCRIPTION — SEE ATTACHED
BDIV151ON
-2-0
(-At tLe
PHONE
S 3:i'O.7'L3
ZIP
PARCEL NUMBER/S
-PHONE
ZIP
PHONE
ADDRESS
ZIP
Actual Set Backs In Feet
North (South East 'West
Size of Parcel Zone Classification
Type Const. Occupancy Sprinklered
❑Ves ❑No 0 Redid.
Valuation Building Area in Sq. Ft.
Main Floor Upper Floors Garage Area Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
I/NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
❑ BLD. 0 PLMB. I�MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories -
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req•d.
Recd.
Not Req'd.
DESCRIBE WORK
8. LOCCA3 i:w :A:1 C; --r 1
Enum. Dist.
Location (Area)
VALUATION
SOURCE GAS ELECTRIC
OF
UTI LIT ES
WATER
SEWER
Ownership
Public ❑Private 0
USE CODE
9.
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
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 n
DATE OF APPLICATION 7 - ;is-- J -1 SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engines
Utilities
Plans Examiner
SEPA Checklist
Bding Technician
CA
iso
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech. * 17,00
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ (7 co
PERMIT NUMBER
110 - ct,5344 .
04* *17.00
* 1 7.00
*17,006
A *000 8
98432
09-25-81
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'1.1091,,410.81:11 98'4.4 i *.17.-0 0
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL