1980, 04-24 Permit: 80-3962 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT i- M-9)0 -` Ck(S92
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
04 * * 7,00
JOB ADDRESS a
10
' CAS
�{`''�1 /+CX Q (V\L�Cstl LEGAL DESCRIPTION — SEE ATTACHED * 7 0 0 '(7)LOT BLOCK SUBDIVISION PARCEL NUMBER/S *7. O c�i
2 OWNS PHONE
r * 0, 0 0 9
3. 9- '--H 7_F_K—k-. C , q a q'ci C1- L
ADORES ZIP(�(�� / Actual Set Backs in Feet 3 9 6 1 z
• �M1. Q-, `l ( t (0 North 'South East (West 0 4—2 4—8 0
CONTR TOR PHONE Size of Parcel Zone Classification
`ate_o_ � 6479,
4. ADORES ZIP Type Const. Occupancy Sprinklered
(moi ANN,CL...- Dyes ❑No ❑ 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 Unfin. Basement
6.
No.Baths No. Stories No. Rooms No. of Dwellings
TYPE ❑ NEW ❑ ALT. 0 AD'N. 0 RPL. D MVE.
7. OF 0 OTHER
WORK ❑ BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
_ of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) '
8. FEES COLLECTED
VALUATION SOURCE GAS E CTRIC WATER SEWER Ownership USE CODE
9. UTI LOITIES Public ❑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 Building
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 Plumbing
DATE OF APPLICATION /'''. ,5----p SIGNATURE OF APPLICANT ��0. , ...i.,6i,___„ .._.„—Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA n_-�
Planning :..) `.
w
Mobile Home
Fire Marshall :,.
Co. Engineer Other (Specify)
Utilities 00
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
B e hnician PERMIT IS NONTRANSFERABLE 0 Q o -i -
A. o,LAAJ1A.,t-V1 J PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL