1980, 11-12 Permit: 80B-3630 Wood StovePLAN NUMBER
(D1
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. JOBADDRESS
6 M c t-ofdhuto KO/\0 •
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3
4.
OWNER
o ---J TILL -Mt*
PHONE
PARCEL NUMBER/S
ADDRESS
1 13,0) I4 -I03(0
NTI�A
CO_CITOR '
IPI 4—
PHONEHONE
Actual Set Backs in .Feet
North !South East West
Size of Parcel - I Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Oyes ❑No ❑ Req'd.
DESIGNER
ADDRESS
PHONE
Valuation . IBuilding Area in Sq. Ft.
ZIP
Main Floor
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basement
TYPE (d NEW 0 ALT. 0 D N. 0 RPL.
7. OF
WORK 0 BLD. 0 PLMB. MECH. 0 M.H.
DESCRIBE WORK
B. kJno✓J &vr*
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
Enum. Dist. I 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 r_,.ting construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPE
DATE OF APPLICATION // — / Y _ cJ" SIGNATURE OF APPLICA
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marsha
Co. Engineer
Utilities
Plans Examine
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
-cam
Other (Specify)
TOTAL $
— R'n' NUMBER
M to S - s3G'3v
04* *7.00
*7.00
*7.006
A *00,0 8
36292
1'1-12-8,0
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
l'11T.12lii 8UI
DATE ISSUED PERMIT NO.
31610'5
*7.0.0°a0:
TOTAL