1982, 11-10 Permit: 82B-0853 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
`7P(/ SZ5-- 0653
ex NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES _
JOB ADDRESS '' 4r, 1 * ( O
1. "e. . `15cia `✓pv,.L,t-yLtk„to�a{ LEGAL DESCRIPTION — SEE ATTACHED * 2 0 0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. A * j 5 C.
OWNER PHONE 0 5 `` ,
3. e0 C:)(_.:vr...- CTZG.-34:pOl
ADDRESS ZIP; Actual Set Backs in Feet 1 1 — 1 0—8 2
e • IGel OP) tj '-f t.)4 V /� cicAb5-7 North 'South East 'west 7 9
CONTRACTOR .,`/ PHONE Size of Parcel Zone Classification
ADDRESS ZIP Type Const. Occupancy Sprinklered
Pc PAZ.4. "`��� Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. `�
ADDRESSZIP Main Floor Upper Floors Garage Area Storage
CHANGE OF USE F TO Area of Decks Finished Basement Unfin. Basement
6.
No.Baths No. Stories No. Rooms No. of Dwellings
TYPE
iiNEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7, OF / 0 OTHER
WORK
0 BLD. 0 PLMB. [F�MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. !Location (Area) T
8 :.re)0Dt ci `"1 4, --i-c!,
p O tr I FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
li"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 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 APPLICATIOI' —tO_. L--"L- SIGNATURE OF APPLICAN �� � k1�O 1�-.) Mech. 2 'a.
SPECIAL APPROVALS SPECIAL CONDITIONS: `1
41)
NAME DATE Plan Check
Env. Health
101
SEPA
Planning
Fire Marshall Mobile Home w
ii
Co. EngineerIlik4 Other (Specify)
Utilities TOTAL $Z'- a7
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building Technician PERMIT IS NONTRANSFERABLE 1'1�=. 1 d"8`-2' 8 5.3 z * 2 0.0 0 a iii-. -
97 c 0 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL