1981, 03-03 Permit: 81A-1981 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 4 COPIES
1
2
JOB ADDRESS 1*`�
LOT BLOCK SUBDIV SION
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
ADDRESS
PHONE
Z I P q U�
PARCEL NUMBER/S
Required Set Backs In Fee
North (South
East
e
CONTRALTORf*c•
x2 (N.)
PHONE
Size of Parcel Zone Classification
ADDRESS
ZIP
Type Con
Occupancy Sprinklered
Dyes DNo ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
D W L Area
Basement Area
Garage Area
Storage
CHANGE OF USE FRO
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
L7 NEW 0 ALT. 0 A N. 0 RPL. 0 MVE.
0 BLD. ❑ PLMB. ' lL CECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floo
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd
Rec'd.
Not Req'd
DESCRI WOff' &—\c
/o Li�
8.VALU TI N 1'�P_i Source ` GAS
of
9. Utilities
ELECTRIC
WATER
SEWER
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.
DAT
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilitie
Zone Clearance
SEPA ChecklIst
SPECT
CONDIT
NS:
a
. r
-c-
APPROVED
'
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
DATE
04* *17.0.0
*1700 N
*17.0.06
*Q0.0 8
1.9 at
03-03-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BFCOMA PERMIT.
o 3rI3Bl'.l3
19 8,1;z. * 1' 7.0 010.