1980, 04-14 Permit: 80-3441 StovePLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
I I1
SPOKANE COUNTY — BUILDING CODES DEPARTMENT gd
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. -4&-9 2-3 /7 46ve-- 6u/z i LEGAL DESCRIPTION -SEE ATTACHED
7R
3.
ADDRESS
;J-
, Z31 5? Ou/L C'Cz,/,?r
6IC-R14,01kE4 wA
PHONE
Actual Set Backs in Feet
Jorth (South
n
�l 4 U
CON RACTOR PHONE /Size of Parcel Zone Classification
e ��2.r E rr 6�<�C Z-,O�'Se
4' AD ESS Z Type Const. Occupancy Sprinklered E !!17-
%I C % //VG lG �1/
/ / es,2 —;:�
❑Yes ❑No ❑ Req'd.
DESIGNEFY PHONE Valuation
Building Area in Sq. Ft.
I - - --
5.
ADDRESS ZIP Main Floor Upper Floors
Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. '—"_" _
No. Baths No. Stories
No. Rooms No. of Dwellings
TYPE�y
❑ NEW ❑ALT. Jal AD'N. E) RPL. [I MVE.
7, OF ❑ OTHER
❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE
Req'd. Recd. Not Req'd.
WORK
of EXEMPTION
I
D,F.SgRIBE WORK Enum. Dist. Location (Area) FEES COLLECTED
8• —
VALUATION CE GAS ELECTRIC WAT R SEWER Ownership USE CODE
9. UTILI E `! � 1--2 — Public ❑ Private ❑
Single $
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
Building 7'.00
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
Plumbing
DATE OF APPLICATION V SIGNATURE OF APPLIC
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
BuAdi Tejh,PjcianPERMIT IS NONTRANSFERABLE
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