1980, 10-07 Permit: 80B-1573 WoodstovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
2.
3.
l/ APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
�". g 9 TH
LEGAL DE$CRIPI;ION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWNER
EL t%•=6irn cs4Kie V
ADDRESS
6s 6Sici fir'
PHONE
Qr2- /526'
ZIP
CONTRACTOR
4. ADDRESS
PHONE
Actual Set Backs in Feet
North (South LEast (West
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation (Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin- Basement
TYPE
7. OF
WORK
LJ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
,�,(
0 OTHER
BLD. ❑ PLMB. L'J MECH. 0 M.H. 0 POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. LOC30a.E3 iV a/ti S76tl.44 c
VALUATION GAS
9. 5C= .
SOURCE
OF
UTILITIES
u% M.4.5 efte�rh, �Y
Enum. Dist. I Location (Area)
ELECTRIC
WATER
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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
/We°
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
pilcATechnician
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single
Building
Plumbing
Mech. # 7'
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$17.c.0
M
PERMIT NUMBER
�o rS 73
02* *1000
*1000
1 5 7. 1 2
10-07-80
2 6479.
04* *700
*7.00 16
1 57.2
10-07-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
7�0`LO 7'-8'0'
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
157.3 *17.00°
PERMIT NO. TOTAL