1981, 10-26 Permit: 81B-1112 WoodstovePLANUMB€
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
1.
2.
3.
JOB ADDRESS
SUBDIVISION
LOT
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER viao
pp��c.,
ADDRESS
':ygc'-7 .w OD 2 [2‘Li.r
CONK CTDr.
�I
4' ADDRESS
HONE
ZIP
•47197--i°G
Actual Set Backs in Feet
North 'South lEast (West
PHONE
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Elves No ❑ Req'd.
DESIGNER
rJ. ADDRESS
PHONE
Valuation 1 Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
TO
El/NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. ❑ 'MECH. ❑ M.H. ❑ POOL
Area of Decks
Finished Basement
Storage
Unfin. Basement
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
8. 6'v C7c) 2 <J1 -\
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Rec'd.
Not Req'd.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
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
DATE OF APPLICATION 1 0 - L— ` SIGNATURE OF APPLICANT-L-1'`,,��``,,
tiQ \-
SPECIAL APPROVALS SPECIAL CONDITIONS: I., ‘
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
6chnicia? e-
C� a S
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
1
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 17
PERMIT NUMBER
2)t5 -ill
04* *17,00
*17.00 rn
*17.006
A *0,00 0
111.12
10-26-81
< 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1':0'.2 6 -8'1 11 L2 z *1 7. 0 0 a°. —
DATE ISSUED PERMIT NO. TOTAL