1982, 10-19 Permit: 82A-9765 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
JOB ADDRESS
t 502- W r•)'E�.
LOT
BLO K
UtiUI VISION
OWNER
3. d C. -t -k A 6 Lo tul.E
4.
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
ADDRESS
15 Da J\3 *E-►— P
CONTRACTOR
ZIP
c\c1 Z o Ce
ADDRESS
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
PHONE
Actual Set Backs in Feet
North 'South
Size of Parcel
East 'West
I Zone Classification
Type Const.
Occupancy
Valuation
Sprinklered
Oyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Main Floor
Upper Floors 1 Garage Area
Storage
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
'=YNEW ❑ ALT. D AADD'NN. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWE R
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private ❑
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
161, 7) _
DATE OF APPLICATION JO —7/g — got
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMB
¶1 � )
04* *2000
976.42 1
10-19-82
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-1'9-82 976,52 *20.00 JO
ISSUED
PERMIT NO. TOTAL