1981, 05-04 Permit: 81A-4276 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
fri f.
SPOKANE COUNTY — BUILDING CODES DEPARTMENT ?)t A -4-2-1(,,,
0 NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS PARD TO MAKE 3 COPIES
JOB ADDRESS
�. ES 12_1!)0q �ah42� LEGAL DESCRIPTION — SEE ATTACHED 0 4 * * 1 7.0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 I. 0 0 —n
2 OWNER PHONE * 1 7.D O ZS
3. '7O14N VDfiASc_ t olZS- ILS 1 A * 000
ADDRESS ZIP Actual Set Backs in Feet
E., t2 3ba 61-iA2P 636V2.-il0 North 'SouthEast IWest 4 2 7.5 7
CONTRACTOR PHONE Size of Parcel Zone Classification 0 5- 0 4-8 1
6, IVIS
4. ADDRESS ZIP Type Const. Occupancy Sprinklered z 6 4 7 9.
SAME Dyes ❑No D 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.
TYPE ,�/ No. Baths No. Stories No. Rooms No. of Dwellings
Lrl NEW 0 ALT. 0 AD'N. 0 RPL. ❑ MVE.
7, OF ^J ❑ OTHER Req'd. Recd. Not Req'd.
WORK
0 BLD. 0 PLMB. Ind MECH. 0 M.H. 0 POOL CERTIFICATE
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) FEES COLLECTED
8. 'IAJDbobaaN sktk 'r t 1
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public 0 Private 0
Single $
I 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 INSPECTIONS Plumbing
DATE OF APPLICATION 7 ` (Q ) SIGNATURE OF APPLICANT W'\.Mech. 4 t7°0e7
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA 4
Planning Q
U
Mobile Home 'u
Fire Marshall .4
ii
Co. Engineer Other (Specify)
Utilities
TOTAL $ r7•al)
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
'
Bu'ding Technician PERMIT IS NONTRANSFERABLE 0 71'' 0 4.—'01<
Bt.pl4 27,6 z *17.110 °a,11-
� - PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL