1980, 09-05 Permit: 80-9687 Wood StovePLAN NUMBER
APPLICATION/PERMIT
G SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
E. /o//O A'55/on/
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWNER
3 /Liss/C76/UTNce
ADDRESS
e. /O//A h//5s/on,
PHONE
9zz—zsee
ZIP
99800
Actual Set Backs in Feet
North (South East 'West
4.
5.
CONTRACTOR
ADDRESS
DESIGNER
PHONE
Size of Parcel 1 Zone Classification
ZIP '
Type Const.
Occupancy
Sprinklered
Dyes DNo 0 Req'd.
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper 'Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
L7 NEW 0 ALT.
0 BLD. 0 PLMB.
0 AD N. 0 RPL.
ErMECH. 0 M.H.
❑ MVE..
0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. tt)cOC
UTILITIES r�t/<2lziiy
SOURCE I GAS
OF
VALUATI O
9.
Enum. Dist.
SrbvE
Location (Area)
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
1 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 REVERSESIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION — 5 �r/ 'SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
Plans Examine
SEPA Checkh
Building Technician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
S ngle $
Building
Plumbing
Mech. 7 Oe7
Plan Check
SEPA
Mobile Home -
Other (Specify)
TOTAL $ %ec
PERMIT NUMBER
80 — 9687
04* *7.00
*7.00
96862
09=05-80
3 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'019,45f- 8?'0' 9 6 8.7 .Z
PERMIT NO. TOTAL
DATE ISSUED
riu7.00aF
>-
8-
La-
WHEN
L