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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