HomeMy WebLinkAbout1980, 12-11 Permit: 80B-4785 WoodstovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
2.
OW ER
3. 0.1/.4_1 .4-7,1_) L p t,d .
ADDRES
CO TRACTOR
4.
AqDRESS
PARCEL NUMBER/S
PHONE
ZIP
9
PHONE
Actual Set Backs in Feet
North 'South East 'West
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
5.
6.
DESIGNER
PHONE
Sprinklered
❑Yes ❑No ❑ Req'd.
ValuationBuilding Area in Sq. Ft.
ADDRESS
CHANGE OF USE FROM
ZI P
Main Floor Upper Floors
Garage Area
Storage
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
D NEW
❑ BLD.
DF�CRIBE WORK
'J[
VALUATION
9.
❑ ALT.
❑ PLMB.
❑ AD'N.
• MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
SOURCE
OF
UTILITIES
GPIS ELECTRIC 1 WATER
Enum. Dist. I Location (Area) r
SEWER
Ownership
Public ❑ 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 regul. i construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Byj g c nicia
'44(
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
/% v4/ A.A-1 •
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
M
PERMIT NUMBER
gO L -- 7
*7.00
*7,00 tn-
478.42
12-11-80
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12 tli'1`f-'810
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
47&52 *7.00°
PERMIT NO. TO 1