1980, 10-13 Permit: 80B-1880 Wood Stove•
PLAN 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
2.
JOB ADDRESS
LOT SUBDIVISION
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
4.
OWNER
C 1 01- t' I� 1bF�lK
ADDjiV-55 C7Ja.-7 f1hJ
CONTCT (R6-
PHONE
9 -2.3 '70
ZIP
Co
PARCEL NUMBER/S
PHONE
ADDRESS
ZIP
DESIGNER
6' ADDRESS
PHONE
ZIP
Actual Set Backs in Feet
NortM1(South East (West
Size of Parcel Zone Classification
Type Const. Occupancy Sprinklered
❑Ves DNo D'Req'd.
Valuation Building Area In Sq. Ft.
Main Floor , Upper Floors Garage Area Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfln. Basement
TYPE
7. OF
WORK
IE NEW 0 ALT, 0Af1 N. 0 RPL. D MVE.
0 BLD. 0 PLMB.I!d'MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
• CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
8.DCO
DESC(i BE WORK e°42;11#
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public D 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 SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
uildingT nician
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
-7."
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
/Y
PERMIT NUMBER
f1 -IPA°
04* *7.00
*7.00
1.87.95
10=13'-8.0
s 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
*7.0O,0J -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL