1981, 11-16 Permit: 81B-1821 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
JOB ADDRESS
1.
E. 8206 Nora
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3.
OWNER
JERRY MOON
PHONE
928-5587
PARCEL NUMBER/S
ADDRESS
same
2199206
Actual Set Backs in Feet
North 'South
East
West
4.
CONTRACTOR
PHONE
Size of Parcel 1 Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Dves DNo 0 Req'd.
5.
DESIGNER
PHONE
Valuation (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
Untin. Basement
y{ NEW 0 ALT. • 0 AD N. 0 RPL. 0 MVE.
0 BLD. 0 PLMB. Ca MECH. 0 M.H. 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.
WOOD STOVE
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public O 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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
elDATE OF APPLICATIONX / � ' �f `CISIGNATURE OF APPLICANT X /.. j "cem
SPECIAL APPROVALS SPECIAL CONDITIONS: •
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B (ding Technician
ere 4, erl 9a'10
6,64
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
S"ngle $
Building
Plumbing
Mech. 17 on
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 17.00
PERMIT htJMBEFa
SJIL3- ley).1
04* *17.00
* 17.00
* 17.006
'A *0.00 8
1820
11-16-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
6'-:8`1 .:
11,821= •*17,00Elie
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED „ PERMIT NO. TOTAL