1981, 09-04 Permit: M81A-8958 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
k-/ APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB gDRESS4,,_, p ppy V�>J LEGAL DESCRIPTION -SEE ATTACHED
LOT I BLOCK ISUBDIVISION PARCEL NUMBER/S
OW JE
3. 0
ADDR SS
CO NT�
4. ADDRESS
DESIGNER
5.
P ONE
�2-42%f'
ZIP Actual Set Backs in Feet
North South
PHONE Size of Parcel
ZIP Type Const. F Occupancy
PHONE Valuation
Zone
Sprinklered
❑Yes ❑No ❑ Req'd.
uilding Area in Sq. Ft.
Garage Area Storage
ADDRESS
ZIP
Main Floor I
Upper Floors
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basem
6.
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwe
�, OF ❑ OTHER
CERTIFICATE
Req'd.
Recd.
Not R
,,�
WORK ❑ BLD. ❑ PLMB. L'7 MECH. ❑ M.H. ❑ POOL
of EXEMPTION
DES
8
RIBE WORK
[90� �%�j
Enum. Dist.
Location (Area) FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER
Ownership USE CODE
OF
9. UTILITIES Public 11 Private ❑ Single $
1 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
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 c nstruction or the
performance of construction. E REVERSE SIDE FOR REQUIRED INSPECTIO Plumbing
DATE OF APPLICATION e SIGNATURE OF APPLICANT— Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
Planning
Fire Marshall
neer
Utilities
Plans Examiner
n PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
SEPA
Mobile Home
Other (Specify)
TOTAL $ _ L/
PERMIT NUMBER
1�r-v%'7v
G-* *1700
�. a 7 n
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'09,.'84:-81' 895.82 *17p0a� _
DATE ISSUED PERMIT NO. TOTAL
0
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