1980, 11-25 Permit: 80B-4209 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT MUMMER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT or -4zq
9-J NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES 4 * * 7. 0 0
JOB ADDRESS
1• E. kei/U tAkFtC.ESc ey LEGAL DESCRIPTION - SEE ATTACHED A 7 0 0 n
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. 420sie_
OWNER PHONE 1 1 — 2 5—8 0
3. 5,3107 6'v r 9zy-087f)
ADDRESS / _ r�� ZIP Actual
/ Actual Set Backs in Feet 6 4 7 9,
Fi , /Zig/O (, /6 c G� err eifo North 'SouthEast (West
CONTRACTOR PHONE Size of Parcel Zone Classification
4. Ss t?06-
ADDRESS ZIP Type Const. Occupancy Sprinklered
Sii471‘ ❑Yes ❑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.
TYPE 5/
No. Baths No. Stories No. Rooms No. of Dwellings
5 NEW 0 ALT. ❑ AD'N. 0 RPL. 0 MVE.
7, OF _/ ❑ OTHER
WORK 0 BLD. ElPLMB. LYS MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION f.
DESCRIBE WORK Enum.Dist. I Location (Area) '
8. 14.)01 004362/iNq' Zrnie l FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWERUSE CODE
Ownership •
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 la regulating construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIO ' Plumbing
tt-V. `7.0 % V _I _ /SIGNATURE OF APPLICANT iii Mech. 47 )
DATE OF APPLICATION
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA >'
Planning O
Mobile Home -- '-u
Fire Marshall CC
U-
Co. Engineer Other(Specify)
Utilities
TOTAL $ 7,et)
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Buildin echnician PERMIT IS NONTRANSFERABLE 1 11-.,-.2'5 718 0 4'2 0;9 z *7.0 0 W. F
j� S /01A PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL