1981, 11-04 Permit: 81B-1490 WoodstovePLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
l./ APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. S. LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK I SUB 5TV ISIO PARCEL NUMBER/S
OWNER
3. ��-
ADDRESS
4s, 1? -o✓ b
CONTRACTOR
4. ADDRESS
`�ari1�
GzAr (.E
DESIGNER
�. ADDRESS
PHONE
ZIP I Actual Set Backs in
NE
ZIP Type Const. I Occupancy
PHONE Valuation
ZIP Main Floor I Upper Floors
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area I Stora(
CHANGE OF USE FROM TO Area of Decks Finished Basement I Unfin. Basement
6.
TYPE ❑ ❑
No. Baths
No. Stories
No. Rooms
No. of Dwellings
NEW ALT. D'N. RPL. ❑ MVE.
7, OF ❑ OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
❑ BLD. ❑ PLMB. MECH. ❑ M.H. El
WORK
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area)
FEES COLLECTED
8 ; S�fxT
VALUATION SOURCES GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIEPublic ElPrivate ❑
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
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
I
Mech. 'T ria
DATE OF APPLICATIO SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
6,479
ndingTechnician_ .-. PERMIT IS NONTRANSFERABLE 1'1..-,0 4' 18 1 14 9 0 Z * 17, 0 0 a.
0