1981, 10-01 Permit: 81B-0134 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT --- L)
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS0 4 * * 1 7.0 0
Kr LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION ( PARCEL NUMBER/S
2. 1 3.3
OWNER PHO E 1 0-01 -81
3. 101,31:17<< C-44M s 9A -5(0"N
ADD SS i942 ,/✓`��(P�7 Actual Set Backs in Feet _ �,(� 7 9,
�� North 'South East (West
CON CTOR PHONE Size of Parcel Zone Classification
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
Dyes ❑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 �� No.Baths No. Stories No. Rooms No. of Dwellings
L+S NEW 0 ALT. 0 AD'N. 0 RPL. ❑ MVE.
7. OF ❑ OTHER - Req'd. Rec'd. Not Req'd.
WORK ❑ BLD. 0 PLMB. MECH. 0 M.H. ❑ POOL CERTIFICATE
of EXEMPTION
DESCRIBE WORK Enum.Dist. Location (Area) '
8. „ �1 c PGi FEES COLLECTED
VALUATION
SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
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 resulating construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPE IONSW. Plumbing 17
DATE OF APPLICATION / �� SIGNATURE OF APPL . •
me,- t G•�''Z x Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA �
Planning O
Mobile Home W
Fire Marshall
ii
Co. Engineer Other (Specify)
Utilities TOTAL $ 1
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
T40.n PERMIT IS NONTRANSFERABLE '
3:010t) 1`` `8 r1 1.342 *1.7, 00a172 –
IV
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL