1981, 02-09 Permit: 81A-1270 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
1.
JOB
(i ADDRESS I v 4AX1A16t V
Lor suH IYl Lies AI 1i ot.)
2. 7
OWNER I r.
o Lo,I/� '�,Iyb�U(
3
ADDRESS
I» 1 1 0 'vl!"�)CV V t%€
BLOCK
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S 1$S 7) — 4707
PHONE
P90
Actual Set Backs In Feet
North (South
East 'West
4.
CON -e
PHONE
ADDRESS
ZIP
Size of Parcel
j4ox-7O
Typo Const.
TVI
Zone Classification
i 4L& . WA
Occupancy
Sprinklered
❑Yes ONo 0 Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO •
Area of Decks
Finished Basement
Unfin. Basement
TYPE t1A NEW
7. OF
WORK QLD.
O ALT.
O PLMB.
0AD N. 0 RPL. 0 MVE.
Ef/ MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not 7..
DESCRIB _ W RKIZ
MpF� l' ft\4N�lt I N 007 C—(o\/&
VALUATION
9. JcQ
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
Enum. Dist.
Location (Area)
SEWER
Ownership
Public 0 Private Y
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 r. . O 6 - ei
SIGNATURE OF APPLICANT -7.4011 1'A Do
SPECIAL APPROVALS
NAME' DATE
Env. F{ealth
t2
Planning
Fire Marshall
Co. Engineer
Nor 12010 •
Utilities
Pl ansjExaminer
u1 « ?'Q.
SEPA Checklist
iltling tniclan
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building 'O
Plumbing •
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
1%
TOTAL $2-7•
PERMIT NUMBER
SIA --(2-10
02* *1000
* 1000 rn
* 10.006
A *000
1268
02-09-8,1
2 6479
04* *17.00
* 17,00
* 17.006
• A *000 8
12692
02-09-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
1'2 7101 *.27:0.0°. I�
PERMIT NO. . TOTAL