1980, 10-16 Permit: 80B-2110 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
1.
2.
3
JOB ADDRESS
LOT
..'eti")
SUBDIVISI N
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
04f NER
ADDRESS
yid
CbtITRACTOR
4. .1. -e1/1/1"/ -ti
ADJD R ESS
DESIGNER
5. ADDRESS
PHONE
9Z? 7d
ZIP �!_
9 g, -z
PHONE
Actual Set Backs in Feet
North 'South East 'West
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation (Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ NEW
O BLD.
O ALT.
O PLMB.
❑ AD'N.
MECH.
❑ RPL.
❑ M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
ESCRIBE WORK
8.
VAL ATION
9.
SOURCE
OF
UTILITIES
GAS 1 ELECTRIC
ATER
SEWER
Enum. Dist.
ILocation (Area)
Ownership
Public 0 Private 0
USE CODE
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 INSPECTIO ,S
DATE OF APPLICATION / 4 P2)
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
'Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bui ding Tech, icia
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
D
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
lJt�
TOTAL $
H
PERMIT NUMBER
* *7.00
* 7,00
* 7,00Y
A *0,00
210,97
10-16-80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
211,0 z
PERMIT NO.
x7.00a.H
TOTAL
›-
CD 0
U
LI-
WHEN
i