1981, 09-21 Permit: 81A-9601 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
1. 470
LOT
2.
BLOCK
Jutiul v IDIUIN
OWN R
3. J L'- .4. v't c,
ADESS
• 1-741 l 3 ixY-,
CONT ,4 R
4.
ADDRESS
PHONE
lFGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
DESIGNER
5. ADDRESS
PHONE
ZIP
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
Actual Set Backs in Feet
North (South
Size of Parcel
East (West
Zone Classification
Type Const.
Occupancy
Valuation
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Main Floor
Upper Floors 1
Area of Decks
PERMIT NUMBER
04* *17.00
* 17.00
* 17.006
A *0.00
960'02
09-21-81
6479.
Garage Area Storage
Unfin. Basement
No. of Dwellings
Req'd. Rec'd. Not Req'd.
Finished Basement
TYPE NEW
7. OF
WORK ❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ RPL.
MECH. ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
No. Rooms
8. DES NtIBE'J�(ORK /
Enum. Dist. I Location (Area)
VALUATION
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private
USE CODE
9.
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 w regulating construction or the
performance of constructio .' EE REVERSE SIDE FOR REQUIRED INSPE 4 S
y6ATE OF APPLICATION
SIGNATURE OF APPLICA I/�.�` . I 144"t1i
7
SPECIAL APPROVAS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
I7
$ 17
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
091-21"- 8''1;
96O,1z *17.00R1-2
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL