1982, 08-09 Permit: 82A-6938 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
JOS ADDRESS
LOT BLO
2.
cs o n
BDI 15 O
4
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OW ER
3. 1 _F
AD E7SS
OS
P OZgNE
-3t 5-7
F� L ss i sn
4.
CONTRACTOR
ZIP
q� o CP
PHONE
Actual Set Backs in Feet
North 'South
East
(West
Size of Parcel 1 Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy
Sprin klered
❑Yes ❑No ❑ Req'd.
5.
DESIGNER
PHONE
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
EW 0 ALT.
❑ PLMB
❑ BLD.
0 AD
TO
❑ RPL.
ECH. 0 M.H.
❑ MVE.
0 POOL
0 OTHER
Area of Decks
No. Baths
Finished Basement
No. Stories
J
No. Rooms
Unf in. Basement
No. o
Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WO
a (k'1oot
1/v'e.'sA-00e.
Enum. Dist.
Locati n (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private
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
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building 1'e4hne1an
IGNATURE OF APPLICAN
SPECIAL CONDITIONS:
•
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check-
SEPA
2o -
Mobile Home '
Other (Specify)
TOTAL $ —
PERMIT NUMBER
SZ A (4936
04, *2000
*20008
A ' *000
69372
08-09-82
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
' 0,'8,;x10' 9 `=`82i
DATE ISSUED
69'3.'84 *20,00 JO
PERMIT NO. TOTAL
0
O
J
tl