1981, 06-24 Permit: 81A-6270 StoveNUMBER 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
DRESS
JOB ADDRESS DRESS LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK ISUBDIVISION PARCEL NUMBER/S
2.
NER PHONE
3.
ADDRESS ZIP Actual Set Backs in Feet
%A�
'�w� �V�� �O�\� —�� North South East West
CON RACTOR PHONE Size of Parcel Zone Classification
4. ADDRESS ZIPp� Type Const. Occupancy Sprinklered
❑Yes ❑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 TO Area of Decks Finished Basement Unfin, Basement
6.
TYPE❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. No. Baths No. Stories No. Rooms No. of Dwelling
7, OF ❑OTHER
WORK 1:1 BLD. ❑ PLMB. XM. ❑ M.H. ElPOOL CERTIFICATE Req'd. I Recd. Not Req'd
of EXEMPTION
DESCRI E WORK S Enum. Dist. Location (Area)
$ � �_\ �`�� �.�_ FEES COLLECTED
VALUATION I SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF Public ❑ Private ❑
9. UTILITIES
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 L_3` o` SIGNATURE OF APPLICA `� Mech.�
SPECIAL APPROVALS
NAME DATE
nv. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ecrrnicitn j
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
/V IPERMIT NUMBER
P,, LA
04* *1700
*17.00
*1700Y
A *0.00
626,9-2
06-24-81
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
8 `, 6 2 Z 0 Zd
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