1982, 08-06 Permit: 82A-6872 Wood StovePLAN NUMBER
APPLICANT:
APPLICATION/PERMIT
SPOKANE CC6NA4' — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERStt SPOKANE, WASHINGTON 99260 / (509) 456-3675
COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3•COPIES
JOB ADDRESS
f.
LOT
2.
BLOCK
E Si 1C.. Noes.,
fUBDNISI ON
LEGAL DESCRIPTION - SEE ATTACHED
3
OWNER
etrx)E
MO'1ZI?lcW
PHONE
R22-3'"FtZ
PARCEL NUMBER/S
ADDRESS
E . i3ilCo No2A
ZIP
cI Q7. -CG
Actual Set Backs in Feet
North 'South
East 'West
4.
5.
CONTRACTOR
Staw.6
ADDRESS
9101°)n&
DESIGNER
PHONE
Size of Parcel I Zone Classification
ZIP
Type Const.
Occupancy
Spr in klered
Dyes ❑No 0 Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement •
TYPE
7. OF
WORK
I`l NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑,,yo N. ❑ RPL.
CJ MECH. ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. Vicar $tie.tJtuC� /Coo
OF
9. UTILITIES
VALUATION SOURCE
GAS
Enum. Dist.
Location (Area)
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 regu)a(jPg onstruction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
IP
s�
DATE OF APPLICATION
SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
SPECIAL CONDITIONS:
Co
Eng nee
Utilities
Plans Examiner
SEPA Check
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
ech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ et)
PERMIT NUMBER -
£32,A • ee72. .
04* *2Q00•
*2Q006
A *0.00
. 6871 4
`08-O6'-82
£ 6479.
S
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
• o�.a,,o+6.812:: 68 x.z z * 2;a o o;a. -
DATE ISSUED
PERMIT NO. TOTAL
d
O
LiJ
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