1980, 10-23 Permit: 80B-2576 WoodstoveN 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. S. 5/yLEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK BDI I ION PARCEL NUMBER/S
2.
OWNER PHONE
3. Z`reU& G u K 9 =�Y32
ADDRESS
ZIP
Actual Set Backs in Feet
J AlC/eoF
`7i�ZC<.
P S
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
aJ,4%1;
4'
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
}/y/E
❑Yes ❑No ElReq'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
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 Dwelling
TYPE ❑ NEW 1-1 ALT. ❑ RPL. ❑ MVE.
7, OF ,❑/AD'N.
❑ OTHER
❑ BLD. ❑ PLMB. AQ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd_
Not Req'd
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist.
Location (Area)
8. &-bo o aunrw�-J 4' szro v c�
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
UTILITIES
Public ❑Private C]
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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Building
I
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
}�
N L%U�OJJEI-�) -JiDATE OF APPLICATIOa3 - 1f O SIGNATRE OF APPI (CANT -All-j
Mech. Al0
SPECIAL APPROVALSI SPECIAL CONDITIONS:
NAME DATE
rianning
Fire Marshall
Co. Engineer
Utilities
ns Examiner
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
,'I80� Z's
TOTAL $ 2.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Buildinp,Technician PERMIT IS NONTRANSFERABLE j i� �! �. ( ,,� ,7 6 �? Yr �j �,