1980, 06-25 Permit: 80-6310 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.
LOT
2.
BLOCK
8D °-a. e -
SUBDIVISIO
LEGAL DESCRIPTION - SEE ATTACHED
3.
OWNS
ADDRES
ZIP 6
Actual Set Backs in Feet
North 'South East 'West
4.
✓v. tiP%�itzte-s)
PHON
PARCEL NUMBER'S
CONTRACTOR
PHONE
Size of Parcel Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy Sprinklered
DYes ❑No ❑ Req'd.'
5.
DESIGNER .
PHONE
Valuation
Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
6.
TYPE
7. OF
WORK
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
❑ BLD. I] PLMB. 0 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. e
•Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public O 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 REVERSEISIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
/a3
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planting
Fire Marshall
o. Engineer
Utilities
Plans Examiner
SEPA Checklist
B ng Tec nician
n.. ra
SPECIAL CONDITIONS:
FOR GAS APPLIANCES .
PIPE SIZES
PIPE LENGTHS •
3TUS
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing•
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $ 7%
ft
PERMIT NUMBER
04*
*7.00
*7.00
*7.006
*000 3
63092
06-25-S0.
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
b 6 2 5f4Si'0' 6 '31 0.5 se7 00'0i2
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
PERMIT NO
TOTAL