1980, 10-14 Permit: 80B-1963 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 yy(�
1 �OT
//4,06
BLOCK SU
2.
ciyu NER
3 .4 I /et (3,I e—'
LEGAL: DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
PHONE
qg- 29Ie'
ADDRESS
CONTRACTOR
4. ..a/CA/1 "
�
D R ESS�
<a-ArieC -
DESIGNER
5. ADDRESS
ZIP
Actual Set Backs in Feet
North 'South
East
(West
PHONE
Size of Parcel 1 Zone Classification
ZI P
Type Const.
Occupancy
Sprinklered
Oyes ❑No D Req'd.
PHONE
Valuation Building Area in Sq. Ft.
ZI P
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
MECH.
❑ RPL.
❑ M.H.
❑ MVE.
0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
,DESCRIBE WORK,�J
8.,�2( {(,tdj',Y. a GCQ�C_
VALUATION
9.
SOURCE
OF
UTILITI ES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist.
1 Location (Area)
Ownership
Public 0 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 INSPECTI9 S '�
DATE OF APPLICATION J SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examine
SEPA Checklist
SPECIAL CONDITIONS:
Building Tec nicia
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single S
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
do
TOTAL
/vi
PERMIT NUMBER
04*
*7.00
*7.00
1962-2
10-14-80
6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1 0 - 1 4 -'8 0'
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
L26,3,(1 *7.00°
PERMIT NO. TOTAL