1981, 10-12 Permit: 81B-0568 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENTE511-6
_ 'E5
C.)
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED 0 4 * * 1 7. 0 0
1. e•. 1324- rh * 1 7. C:, 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. * 1 7.00
OWNER PHONE
3. cA121. Ci...'.ora..E g,0-604+ A * 0. 0 ,'
52
ADDRESS ZIP Actual Set Backs in Feet 5 6 7 -
6, (.- -'D..A- Cb-rt t- Ota 2.�Cr. North 'SouthEast (West
CONTRACTOR PHONE Size of Parcel Zone Classification 1 0- 1 2-8 1
4' 9.
ADDRESS ZIP Type Const. Occupancy Sprinklered 6 4 7
Elves ❑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
IJ NEW ❑ ALT. 0 AD'N. ❑ RPL. 0 MVE.
7, OF ❑ OTHER
WORK ElBLD. ElPLMB. MECH. ❑ M.H. CIPOOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area) T
FEES COLLECTED
8. &ADOO t� CA Ni I •''COVE
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
9. d.
oOF
f EXEM
Public ❑Private ❑
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 1 / Plumbing
IIIco
DATE OF APPLICATION�D ' O � SIGNATURE OF APPLICAN �� i[ i//�./� -I Mech. ��
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check _
Env. Health
SEPA }'
Planning 0U
Mobile Home LU
Fire Marshall "'1
6:
Co. Engineer Other(Specify)
Utilities
TOTAL $ V-1. O
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
5 G
B ilding Technician PERMIT IS NONTRANSFERABLE 18 ! 5 �,$ z * 1 7, � O
�°a
�y PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL