1983, 07-13 Permit: 83A-6420 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 ADD SS
1 tt)0 C._ `7 c `
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
2.
3 °�v(( g c
ADDRESS
fccO C. 7
CONTRACTOR
4. ADDRESS
DESIGNER
5. ADDRESS
PARCEL NUMBER/S
HONE
4 ZF S 7F
PHON
y
'19
z67 --
PHONE
Actual Set Backs in Feet
North !South East 'West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ENo ❑ Req'd.
Valuation 1Building Area in 5q. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
•
ALT. 0 AD'N. 0 RPL. 0 MVE.
0 PLMB.
1MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
u YSib✓6 tc F' -U c
Enum. Dist.
Location (Area)
VALUATION SOURCE
OF
9. UTILITIES
GAS
ELECTRIC
WATE R
SEWER
Ownership
Public 0 Private 0
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 INSPEC 1Of�S
DATE OF APPLICATION 14(----18'3 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
uild1Tq.T ech ni
4.
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
1Glech. 2 �-
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
04* *2000
*20006
A *000 8-
641.92
07-13-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 7 r-��1`'3�_ 8 3, 6 4 2 0
*20.00 -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL