1981, 10-07 Permit: 81B-359 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. E•. 1/got MAIN AV -
+EGA: DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWNER
3 P1c.K }-kcvtR-
ADDRESS
N. 1010 W009 WAXY)
PHONE
`i SG -3coo
RP,
ZIP
q9 206
Actual Set Backs in Feet
North 'South East 'West
CONTRACTOR
4. ADDRESS
PHONE
Size of Parcel Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Dyes DNo 0 Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation I Building Area in Sq. Ft.
21P
Main Floor
Upper Floors I Garage Area
Storage -
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
Cl NEW 0 ALT. 0vAO N. 0 RPL. 0 MVE.
0 BLD. 0 PLMB. E7 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. t0000 STOVE.
VALUATION
9.
Enum. Dist.
1 NS'TAU-A—[7oN
Location (Area)
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 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 ,b -'b) SIGNATURE OF APPLICAN
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
r -r00
1
AX -
10
K
10 lc
PERMIT NUMBER
SIB— 359
04* *1700
*17,00 t
*17.006
. A' *Q00 8
3582
,10-07-8'1
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
.!1.00`410-1
11.0i.417it83;5.92 *17:0'0 a%
DATE ISSUED PERMIT NO. TOTAL