1980, 11-21 Permit: 80B-4079 Wood Stove PLAN NUMBER APPLICATION/PERMIT r� PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT ' J e) 0 - 40 9'
(1/ NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
,.J06 ADDREssi(LEGAL DESCRIPTION — SEE ATTACHED 0 4 * * 7. 0 0
16 /.3a0:9 r//X"• )(/
LOT BLOCK SUBD I ION PARCEL NUMBER'S * . .0 V
2. y_
OWNER 67C1')/7/21/7
� PHONE * 7' c"
3. Macy 4, 67/7/� 1/ �z n��/ A * o, 0 0
2DDRE7S�S /U �i/ ZIP
y3 7 { Actual Set Backs in Feet 7
/•.7G��0 �/`-//7yt,C:// `/ �:7`/ b North !South East (west /�0 /.8
CONTRACTOR / PHONE Size of Parcel Zone Classification 1 1 —
2 1 -8 0
4. ADDRESS c� ZIP Type Const. Occupancy Sprinklered 4 7 9,
❑Yes ❑No 0 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 Unf in. Basement
6. E//E, GC4re,0/
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
NEW 0 ALT. El AD'N. 0 RPL. 0 MVE.
7. OF ❑ OTHER -
WORK 0 BLD. 0 PLMB. Iii MECH. ❑ M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum.Dist. Location (Area)
8. T.-44.541111
I 'I � �-1 S 0 U k)r I FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWERUSE CODE
Ownership
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
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. SIGNATURE OF APPLICAN • � / ', i __ Mech.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
7 ,o-t)
DATE OF APPLICATION /// 7C/O i1 _
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA c.•
Planning ,T
c,)
—
Fire Marshall Mobile Home =�
iu
Co. Engineer Other (Specify)
Utilities 7 I v V
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THI$BECOMES A PERMIT.
B .g c nician PERMIT IS NONTRANSFERABLE I 1-2 1"8'0 4'0 7.9 g *7.0 0 °a �'t -
�� ` PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL