1981, 04-27 Permit: 81A-3963 Wood Stove JPLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
1 SPOKANE COUNTY — BUILDING CODES DEPARTMENT /A 'w, 3
x 0/ NORTH 811 JEFFERSON / SPC,KANE,pWASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. s.1 52-o S-ktetOUM-TI-I 12-01\0 LEGAL DESCRIPTION - SEE ATTACHED * 1 , ,
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
* i
2.
OWNER PHONE
3, D141& ELL.. 5- io ft1S0hi el'23'--o7lo
ADDRESS ZIPIPActual Set Backs in Feet
S- 152-0 SKIP WOP—Tt-1 �.o /7 L/' ci2.OJ, North 'SouthEast 'West r n 1
CONTRACTOR PHONE Size of Parcel Zone Classification t ` f
.51M41 t. + n
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes 0 N ❑ 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
LJ NEW D ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF 0 OTHER
WORK IDBLD. ElPLMB. a1 IECH. ❑ M.H. ElPOOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum.Dist. Location (Area)
8. W(?DD S T1�1JE L S�AW�T(VN FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
9. S'oc�a x• UTI LLITIES Public ❑Private ❑ 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 egulating construction •r the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIO Plumbing
ic2 7--` �( Mech. /
DATE OF APPLICATION SIGNATURE OF APPLICANT �)i
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA
n
Planning r_D
r,)
Mobile Home "j
Fire Marshall
(s 4j- ots U
Co. Engineer Other (Specify)�/t AX
O"O
Utilities y
TOTAL $ , AY
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building Technician PERMIT IS NONTRANSFERABLE X0141-27.,-B,'it 3.9.6 3 Z, * 1'Z 0 0 2
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL