1981, 10-02 Permit: 81B-0165 WoodstovePLAN NUMBER
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
1.
2.
JOB ADDRESS
X05 f---.;'r•LOT BLO K SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
3 OWNiEZ 014f
ADDRESS tUl
CONTRALTO
4' ADDRESS
5-5..)1E... 0
5;8
120-37
Actual Set Backs in Feet
North !South East 'West
PHONE
ZIP
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation 1Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
(NEW 0 ALT. 0 D'N. 0 RPL. 0 MVE.
,
0 OTHER
VJ BLD. 0 PLMB. MECH. 0 M.H. 0 POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WOR
8.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
W
1 C2010v��
ELECTRIC
WATER
SEWER
Enum. Dist.
Ownership
Public 0 Private 0
Location (Area)
USE CODE
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
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
DATE OF APPLICATION
lb
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buil Te ru,cian
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
17
TOTAL $
71A
PERMIT NUMBER
*
16
it v
_,-C,(_ 1
6,4 79)
*1C u 0
*1 CONS
* r�
1G -UL -P1
6 9,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
16.5. *2.7002i' -