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1981, 12-29 Permit: 81B-3034 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. e5 -3t (o N GPA LOT SUBDIVISION 2. BLOCK LEGAL DESCRIPTION - SEE ATTACHED • OWNER 010,03 ADDRESS `t' F E. 83t co •r olt, C. 10E. PHONE Gf24-3-7ae PARCEL NUMBER/5 ZIP c?C1'2p 6 4. 5. CONTRACTOR C; AM1'vitc, ADDRESS DESIGNER PHONE ZIP PHONE ADDRESS ZIP Actual Set Backs in Feet North 'South East 'West Size of Parcel Zone Classification Type Const. • Occupancy Sprinklered ❑Ves ❑No ❑ Req'd. Valuation Building Area in Sq. Ft. Main Floor Upper Floors Garage Area Storage CHANGE OF USE FROM 6. TYPE 7. OF WORK TO Area of Decks Finished Basement Unfin. Basement dNEW ❑ ALT. ❑,AD N. 0 RPL. 0 MVE. 0 BLDG ❑ PLMB. LrJ MECH. 0 M.H. 0 POOL 0 OTHER No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE WORK B. LDOrDne,ctn.ra1NG VALUATION yOURCE GAS OF 9. UTILITIES 5--c, ELECTRIC WATER SEWER Enum. Dist. Location (Area) !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 regulating construction or the performance of construction. SEE REVERSE EEjSIIIDE FOR REQUIRED INSPECTIONS �'� DATE OF APPLICATION/.2 — 2. 9- �2j'/� SIGNATURE OF APPLICANT /K/w..ic.e7 SPECIAL APPROVALS NAME GATE Env. Health Planning FI re -Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist • B Ing Technician SPECIAL CONDITIONS: PERMIT IS NONTRANSFERABLE FEES COLLECTED Single $ Building Plumbing g,1� Mech. `` 17.C3 Plan Check SEPA Mobile Home Other (Specify) TOTAL $ I% °ce rn PERMIT NUMBER 818-503c+ 04* *17.00 *17.00 to *17.008 A *000 0 30332 ' 12-29-81 2 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 1 1214 9 4,8111 3.03. 41 5 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED *11'7 0'0 PERMIT NO. TOTAL 0- 0 O U -1