1980, 01-28 Permit: 80-609 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMITNUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT ^lCJ
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE 22----7.z., .t,V) /9kd
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES C l * * 7.0 0
JOB ADDRESS *7,0Q f
1. MO Z /-71G eLEGA'L DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S *7.0 0 6
2. E * 0.0 0 0
OWNS PHONE
3. `� . -e. 7z-i--eeeJ,,-J'27. 60.8g
ADDRESS IP. Required Set Backs in Feet
tea--zo�/' y/2-0 I/ North 'South East West 0 1 -2 8-8 0
CONTRACTOR PHONE Size of Parcel Zone Classification U[ 4 7 9
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
TYPENo. Baths No. Floors No. Rooms Rec. Room
❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE.
7. OF ,/ ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. 0 PLMB. MECH: CI M.H. I=1 POOL
of EXEMPTION
DESCRIBE WORK �J �� �a �—
8. G,i'4P y 4 -l,L`?_ FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities
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 regulating construction or the
performance of construction. Plumbing
DATE SIGNATURE Mech. 7�
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
r.)c
SEPA O
Planning — 1.,..1
o..
Mobile Home
Fire Marshall ?
Co. Engineer Other (Specify)
Utilities TOTAL $ 7%-
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THISBECOMFS A PERMIT.
0
0LL � CC0, n o * 7. .
DATEI-7
3—S0OFFICIAL
APPROVED FOR ISSUANCE