1980, 05-13 Permit: 80-4705 Wood Stove 'PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 80105'
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARE) TO MAKE 3 COPIES
0 [I. * * 7. 00
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED
1. G. (014i GM ' . * 7,00 rn-
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
* 7, 006
OWNER PHONE
3'
ADDRESS ZIP Actual Set Backs in Feet 4 7 G,ll 2
clot /�
6
E. a1cl C:, -P tzc.,p North 'South East (West
CONTRACTOR PHONE Size of Parcel Zone Classification 0 5- 1 3-8 0
4. ADDRESS ZIP z 6,4 7 9.
ZIP Type Const. Occupancy Sprinklered
Sw.wNc ❑Yes ❑No D 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.
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
CJ NEW ❑ ALT. 0 AD'N. 0 RPL. ❑ MVE.
7, OF 0 OTHERReq'd. Recd. Not Req'd.
WORK
0 BLD. ❑ PLMB. IVMECH. 0 M.H. 0 POOL CERTIFICATE
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area)
FEES COLLECTED
8. W0050 uQv°v L(QC‘ To I✓r✓ I
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 regulating construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing' / .� n // G/ Mech. Al 7.Q 0
DATE OF APPLICATION SIGNATURE OF APPLICA 41
SPECIAL APPROVALS SPECIAL CONDITIONS: t
NAME DATE Plan Check
Env. Health
SEPA ).-
o_
Planning a
r)
Mobile Home '=.
Fire Marshall ,y
Co. Engineer Other (Specify)
Utilities
TOTAL $ 7 00
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
B111ing echnician PERMIT IS NONTRANSFERABLE 055•` 1°3 _8.0 7 0. 5 z 7 (�� (� o'�
- c 2.-a-viva, PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT °.1 �L
NO. 1 O�f