1980, 10-15 Permit: 80B-2081 WoodstoveNUMBER APPLICATION/ PERMIT
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
LEGAL DESCRIPTION — SEE ATTACHED
LOT BLO K U IO PARCEL NUMBER/S
O?Y2.
NER PHONE
ADDRESS
ZIP
Actual Set Backs in Feet
r
�
_ _
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
t '
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor I Upper
Floors
Garage Area I
Storage
CHANGE OF USE FROM
Area of Decks
Finished Basement
Unfin. Basement
6.
T;__
No. Baths
No. Stories
No. Rooms
No. of Dwelling
TYPE 1-1 NEW 1:1 ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
❑ BLD. ❑ PLMB. [ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
I
DESCRIBE WORK
Enum. Dist. I
Location (Area)
FEES COLLECTED
8
VALUATION
I SOURCE
GAS ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
UTILT_
OITIES_L
I
Public ❑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
in nstruction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT
Plumbing
nATF OF APPLICATION %/��t'v is SIGNATHRF OF APPLI
.r�Z�
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
ning
Mar
neer
ns Examiner
Iding Techmcia
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 7✓
PERMIT NUMBER
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
6 4
*7.Ou°1--' -