1981, 04-08 Permit: 81A-3253 WoodstovePLAN NUMBER . APPLICATION/PERMIT PERMIT NUMBER
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 'S LEGAL DESCRIPTION —SEE ATTACHED
OWI R ,
PHONE
3.
ADDRESS
ZIP
Actual Set Backs in Feet
ate-� �!K!
9'�
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4' AD RESS
ZIP
Type Const.
Occupancy
Sprinklered
❑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
s.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF OTHER
❑ BLD. ❑ PLMB. lk MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd
WORK
of EXEMPTION
I
DESCRIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
VALUATION
I SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
UTILITIES
Public EI 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 does not presume
Building
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
nATF OF APPI ICATION 'T `c� — G G! SIGNATHFIF nF APPI ICANT Y.a
Plumbing
Mech. I
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
Buj'dl TePnicia�f
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
X17 0
* 1 7. is 0
152521:-
014 OF --R 1
6.479.
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
i
O4Ir0��.81Q 32 z
*17.0 0