1980, 10-02 Permit: 80B-1321 Wood Stove, FurnacePLAN 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
1.
2.
3.
JOB ADDRESS
6. to
LOT
BL•CK2 r5UBDI' IS N
LEGAL DESCRIPTION — SEE ATTACHED '
OWNER
JOSCPAVever
G. lCGi.Soi y
PHONE
92q- Sa c3
PARCEL NUMBER/S
ADDRESS
e. /OSZS
! 7i9X WEU
ZI P
49zcr. .
Actual Set Backs in Feet
North 'South
East 'West
4.
CONTRACTOR
ADDRESS
At ioit
C.s ntyi
5
//EQct Sit
PHONE
9ZG—
Size of Parcel 1 Zone Classification
ZIP
9re -
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Rec'd.
5.
DESIGNER
PHONE
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unf in. Basement
7.
TYPE
OF
WORK
02 NEW 0 ALT.
❑ BLD. 0 PLMB.
0AD N. 0 RPL. 0 MVE.
Kl MECH. 0 M.H. 0 POOL
0 OTHER
No: Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Rec'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
B. latoschifftratitme66 Tc, ✓6- < /uo,000 3r re,Ace
VALUATION SOURCE �,V7-
GAS
OF
9. UTILITIES
X
ELECTRIC
W arWATER SEWER
Enum. Dlst: .
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 INSPECT ONS
DATE OF APPLICATION /0/2J80 SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examine
SEPA Checklis
Build) ng Technician
Cnn
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
.Plumbing
Mech.
Plan Check
SEPA
4,9.00
Mobile Home
Other (Specify)
TOTAL $ /9.Oo
14
PERMIT NUMBER
8oti -1321
011* *19.00
*19.00
*19.006
A *Q00
1 320
10-02-80
R 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
2104-:0;:2''8101
DATE ISSUED
l Zl'Z *19.00°e
PERMIT NO. TOTAL
›-
0-
0 fL0
v
J
LL