HomeMy WebLinkAbout1981, 09-29 Permit: 81A-9996 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. A R S LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK 15UBDIVI510NPARCEL NUMBER/S
2.
OWN 1 LL
/ PHONE
3.
ADD ES S �
Z P �
Actual Set Backs in Feet
North South East
West
CONTRA TOR
PHONE
Size of Parcel
Zone Classification
,foM
Ell
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Fioor 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. ❑1 AD'N. ❑ RPL. ❑ MVE.
7 OF ❑ BLD. ❑ PLMB. LTJ MECH. ❑ M.H. ❑ POOL ❑ OTHER
CERTIFICATE
Req'd.
Rec'd.
Not Req'd
WORK
of EXEMPTION
DESCIfIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
8 C7
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
UTILOITIES
Public El 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
Plumbing
DATE OF APPLICATION— -Z 1 -'3 1 SIGNATURE OF APPLICANT LJ
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
uiI i_=jTeCnictn
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ,
WHEN MACHINE VALIDATED IN TH
THIS BECOMES A PERMIT.
0 81
999,
91-2' 9-" 1
4
6. Jr 7.
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