1982, 11-15 Permit: 82B-0939 WoodstovePLAN 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. 5 , IZV7 Zi:eUCs LEGAL DESCRIPTION -SEE ATTACHED
LOT I BLOCK ISUBDIVISION I PARCEL NUMBER/S
OWNER
PHONE
1r\)ANN 4R
3=4_
3.-So"kI)
ADDRESS
ZIP
Actual Set Backs in Feet
Cj': Z,o t� �% �
/�"t
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4' ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
-G{}MC
I
❑Yes ❑No ❑ Req'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 ❑ ALT. ❑ D'N. 1:1 RPL. ElMVE.
%, OF 101 OTHER
1:1 BLD. ❑ PLMB. NJ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
I
DESCRIBE WORK
8 VJ �D�u a" i tuC, •�Td il
Enum. Dist.
Location (Area)
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
OF
I UTILITVES
I
Public C3 Private Cl$.
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 construction or the
performance of construction, SEE REVERSE SIDE FOR REQUIRED INSPEC ONS
Plumbing
II �l �'�'"
DATE OF APPLICATIA Lel SIGNATURE OF APPLICAN
_
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
v. Health
riannmg
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
PW�iIdin�, Technic _ PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)e� ,
TOTAL $
- IPERMIT NUMBER
82 -ag7f
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1`1 5'-8�2 9 3 9 z
*20.000F' -