1982, 08-18 Permit: 82A-7240 WoodstovePLAN NUMBER APPLICATION/ PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
L./ APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. S • l�L�\ M,�w -PA�� "C)n , LEGAL DESCRIPTION -SEE ATTACHED
OWNER
3. t3J rt_L'
ADDRESS
CONTRACTOR
4 CQ A4 -
PHONE
ZIP Actual Set Backs in
Z= North Sot
PHONE Size of Parcel
a
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor I Upper
Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
TYPE NEW ❑ALT. ❑ RPL. ❑ MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
7, OF OTHER
,❑,//AD'N.
WORK 1:1 BLD. ❑ PLMB. KJ MECH. 1:1M.H. EIPOOL
CERTIFICATE
Req'd.
I Recd.
Not Req'd
of EXEMPTION
DESCRIBE WORK
Enum. Dist.
Location (Area)
8• W N%
N STCyu+E,
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
I UTILOITIES
Public ❑Private ❑
ingle $
1 hereby certify that I have read and examined this application and have read;the'NICE" ded
on reverse side, and know the same to be true and correct. All provisions ofordinathis
type of work will be complied with whether specified herein or not. The grapermimeto
Building
anudeid
give authority to violate or cancel the provisions of any other state or locaating theperformance
of constructionn. SEQE'REVERSE SIDE FOR REQUIRED INSPECTPlu
ing
OF 9-19-92—
Q�
DATE APPLICATION` SIGNATURE OF APPLICANTMech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
ning
Mar
Co. Engineer
ns Examiner
ng /chnician `
_ _ - - 10- r -
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $20-010
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'8.-l8 82 72402
1 - 2
'•L1'.
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