1980, 10-08 Permit: 80B-1660 Wood StovePLAN NUMBER
(1)
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
1.
2.
3
JOB ADDRESS
a /(� /tel/'/� 't! -
LOT r BLOCK ON z����L�r�/
P n
fa, r • 0/A. •
<.19�C1p iv�c 57- 9
r
OWNER
ORES i•
,D.2/ 7 4ntch cue
CO 'TRACTOR
AIL&
re"LEGAL DESCRIPTION - SEE ATTACHED
PHONE
92�-425'
PARCEL NUMBER/S / 73J2 --J
5.
R E_S.S,n
DESIGNER
S^GNER
•
4I4444lle.
ZIP
992.OG
Actual Set Backs in Feet
North 'South
East •
'West
PHONE
ZIP.
PHONE
Size of Parcel
Type Const.
Valuation
Zone Classification
Occupancy - Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
• Untin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
O PLMB.
❑ ADN.
MECH.
O RPL.
❑ M.H.
O MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
ESCRII BBE/WORK
Ott
ABY
B.tVA �ATION
NIi
9.
SOURCE
OF
UTILITIES
AS
ELECTRIC
At-
WAT2R I SEWER
Enum. DIst.
Location (Area)
Ownership
Public 0 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 REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION to— SIGNATURE OF ABBLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
Plans Examiner
• SEPA Checklis
Bu ding Tech! urian
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
7i
Plan Check
SEPA
Mobile Home
Other (Specify)
•
TOTAL $7 D�
PERMIT NUMBER
8'015"16/6
04* *7.00
*7.00 tn-
*7.006
A *Q00
165.9
10-08-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1,�h0; }S01 16602 `*7`002e -
DATE ISSUE PERMIT NO. TOTAL.
› -
0
Lai -J
LL