1980, 12-23 Permit: 80B-5183 Wood StovePLAN NUMBER
i �ja3/gD
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. C. 'Rao MA'tcv.Jec c_
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2
BLOCK SUBDIVISION
OWNER
3. t uE IAAg,f.Sc+l
PHONE
4:1 \ar7
PARCEL NUMBER/S
0542.-04433
ADDRESS
G . -76,20 T.\nwvVFt_c
ZIP
erg Zoc
Actual Set Backs In Feet
North
South
East 'Wes
CONTRACTOR�
CO
4. +—�U.z Sc..ii1•0•NI
PHONE
- 4$'3-163'
Size of Parcel
Zone Classification
ADDRESS
L •'al A-3 CeA rcaao
ZIP
Lig to-)
Type Const
Occupancy
Sprinklered
Oyes ONo 0 Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
00.00
Building Area in Sq. Ft.
ZIP
Main Floo
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basemen
Un n. Basemen
TYPE
7. OF
WORK
LM7/NEW 0 ALT. ❑ADN. 0 RPL. 0 MVE.
NJ BLD. 0 PLMB. g MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwelling
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.U.) jfl I 14.-24krmD
V6 / MASOA.T't Ctal AI CI
�jVALUATION SOURC GAS ELECTRIC WATER SEWER
9. cat �UTILOITIES
Enum. Dist.
Location (Area)
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 REVERSE SIDE FOR REQUIRED INSP e S
DATE OF APPLICATION 12 / '2' f AO SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health _
Planning
Fire Marshall
Co. Enginee
Utilities
Plans Examiner
SEPA Check!
Building T chnician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building \0.00
Plumbing
Mech.�'Oe
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ I-1.0.0
FP RMIT NUMBER
11 SC7S-143
3
02* *10,00
*1000
*1Q0.06
A *000
51812
12-23-80
2 6479.
04* *7.00
*700 V)
*7.00'6
A *000 8
5) an
12-23-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1,2 E.'2''3i' .01 51:1 &'' 31 • *.17.0 0,2 l -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL