1981, 08-05 Permit: 81A-7789 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — WILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3.COPIES
3.
JOB ADDRESS -
LOT I BLOCK
OWNER
,t eQ
CONTRACTOR
PHONE
ZI P
LEGAL DESCRIPTION - SEE ATTACHED.
PARCEL NUMBER/S
Actual Set Backs In Feet
North 'South
East
West
4.
PHONE
Size of Parcel 1 Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ,❑ Req'd.
5.
DESIGNER
PHONE
Valuation - I Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unf in. Basement
0 NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH.
DESCRIBE
�WORK j �-s
VALUATION SOURCE G S
OF
9. UTILITIES
❑ RPL.
O M.H.
❑ MVE.
❑ POOL
EKOTHER
ELECTRIC
WATER
,SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Location (Area)
Ownership
Public ❑ Private 0
USE CODE
Req'd.
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 INSPECTIO1
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examine
SEPA Check
BUlldin•
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single. $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
•O°
Other (Specify)
PERMIT NUMBER
SIA- —7789
02* *a00
*800 ti)
*aoo-
A *9.00
778.88
08-05-81
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
II 1.
1='0 5H18"1
DATE ISSUED PERMIT NO.
717 832
*8.0.0 Re
TOTAL