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1981, 12-02 Permit: M8113-2344 Wood stovePLAN NUMBER APPLICATION/ PERMIT PERMIT NUMBER SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 U APPLICANT: COMPLETE NUMBERED SPACES -- PRESS HARD TO MAKE 3 COPIES JOB ADDRESS �zC7EYUT LEGAL DESCRIPTION - SEE ATTACHED LOT I BLOCK SUBDIVISION PArCEL. N—UM BER/S 2. OWNER PHONE 3. ADDRESS ZIP , y Actual Set Backs in Feet 0 � ? SaQ—C. civ i �eAa- North South East West CONTRACTOR PHONE Size of Parcel Zone Classification S la w-, Type Const. Occupancy Sprinklered yy�rj ❑Yes ❑No 1:1 Req'd. 4. ADDRESS ZIP 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. TYPE ,_,J No. Baths No. Stories No. Rooms No. of Dwellings LrJ NEW El ALT. 1:1 AD'N. ❑ RPL. El MVE. 7, OFJ ElOTHER WORK 1:1IlQ BLD. ❑ PLMB. MECH. ❑ M. H. ElPOOL CERTIFICATE Req'd. I Recd. Not Req'd. of EXEMPTION DESCRIBE WORK Enum. Dist. Location (Area) FEES COLLECTED 8. k)Sc vE VALUATION SOURCE I GAS ELECTRIC I WATER I SEWER OF Ownership USE CODE 9. UTILITIES Public ❑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 type of work will be complied with whether specified herein or not. The granting of a permit d s not presume Building to give authority to violate or cancel the provisions of any other state or local law re lating constru tion or the performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS /L Plumbing DATE OF APPLICATIONx bt Q Klh 1 SIGNATURE OF APPLICANT Mech. SPECIAL APPROVALS NAME DATE iv. Health Planning Fire Marshall Engineer Utilities Plans Examiner SPECIAL CONDITIONS: Building Technician. PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE Plan Check SEPA Mobile Home Other (Specify) TOTAL $ V-2 00 04* *17,00 * 1 7.00 * 1 7.001 A *0.00 23G 3� 12-02-81 2 6,479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. l 2, -y 0 Z 8 l 2 3 4 4 25 DATE ISSUED PERMIT NO. *17,OO(OL �-J- - TOTAL