1981, 09-28 Permit: 81A-9913 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
JOB ADDRESS ,i
1. i\ �.`t IZ i oe2Cx cA-!
1 LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
BDIVISION
OWNER
3 E J. ice- __(_J_
ADDRESS
PHONE
C7V2. 4-C4
PARCEL NUMBER/S
A 3r v CI.)
:-5 751—��`�c:
ZI P
C (-10 G :
Actual Set Backs in Feet
North 'South [East (West
CONTRACTOR
4. ADDRESS
PHONE
Size of Parcel I Zone Classification
ZI P
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Va tion Building Area in Sq. Ft.
SeY)
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
Lf NEW ❑ ALT. E/ AD'N. ❑ RPL. ❑ MVE.
I 'BLD. 111 PLMB. VJ MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. U—k%OJ3t.2ti , r`v
VALUATION
JUCf . �=
SOURCE
OF
UTILITIES
4.)-! ,4 -'/ C SitAj J
GAS ELECTRIC WATER SEWER
Enum. Dist.
ILocation (Area)
Ownership
Public ❑ Private ❑
USE CODE
I hereby certify that 1 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 INSPECTIONS
DATE OF APPLICATION 7` '1/ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B'din Technician M
SPECIAL CONDITIONS:
fr-
PERMIT IS NONTRANSFERABLE
PFRMIT FXPIRFS ONF YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building *6 to• Fi
Plumbing
Mech. 1- 'ec
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ,,?,7 • C?�
PERMIT NUMBER
02*
* 1 0,00
* 1000
991.'02
09-28-81
2 6479,
04* *17,00
* 17.00
991.12
09-28-81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
r)ATFOI SSI IFIL PFRMIT 9 91.3 Z *•�. /'IOTA . F
FII F rf1PY