1980, 12-18 Permit: 80B-5002 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
2.
JOB ADRESS
. 1711
LOT
BLOCK
L06L
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
3.
4.
OWNER W.
ADDRESS 1
N 711
CONTRACT R
ADDRESS
1o1 vF.-
L,Oc5Js—i
PHONE
7M-- 0(70 5
99-2,0co
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South East 'West
PHONE
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
6.
7.
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unf In. Basement
TYPE
OF
WORK
/NEW ❑ ALT. ,0,D N. 0 RPL. 0 MVE.
0 BLD. 0 PLMB. L'J MECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of 'Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCIIIBE WORK
8. I4000
Enum. Dist.
Location (Area)
9.
VALUATION
•
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 riot. The granting ofa permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating fQnstruction or the
performance of construction. SE�Et REVERSETSIDE FOR REQUIRED INSPECT!gAF61
DATE OF APPLICATION �4
i' / / — CJ V SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
�7 r 00
x,00
PERMIT NUMBER
2'° 5002--
044 *7.00
*7.00 V)
*7.008
A *0.00
500.1,3
12-18-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•
11'248118'bl •
5sQ2'Z *7.00a
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL