1980, 10-15 Permit: 80B-2044 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. IBIS HA?CkE
LOT LOCK SUBDIVISI N
LEGAL DESCRIPTION — SEE ATTACHED
3.
4.
..��-�(
arsts15E-
ADDRESS
CONTRAc XI I'l-'r733 cet9t-vs4\C/
3PHitylONE, 4 3,
PHONE
PARCEL NUMBER/S
ADDRESS
ZIP
5.
DESIGNER
PHONE
ADDRESS
ZIP
Actual Set Backs In Feet
North (South East (West
Size of Parcel Zone Classification
Type Const. Occupancy Sprinklered
_ ❑Ves ❑No ❑ 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
Unfin. Basement
TYPE U` NEW 0 ALT.
7. OF
WORK 0 BLD. 0 PLM a.
0 AO N. 0 RPL. 0 MVE.
Lel 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.
DESCRIBEMK ,
8. Yx� O � ✓ cv'&
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
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 INSPECTIONS /
DATE OF APPLICATION /L` & V SIGNATURE OF APPLICANT d
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
, Plans Examine
SEPA Checklist
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
7, 00
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
04* *7.00
*7.00
*7.008
A *0.00
204.38
110-15-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. '
41;0.':x1,11 5)001 2' 0 A 05 i 'Q 7.0 0, 21.
DATE ISSUED.
PERMIT NO. - TOTAL