1981, 09-29 Permit: 81A-9965 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 ADDRESS
1. 6- , c3
LOT
2.3
BLOCK
3
LEGAL DESCRIPTION - SEE ATTACHED
SUBIDIVISION
N0o0 L- NI ti
OWNER
7C'Iv �' i,\11
3 ADDRESS
7C-.7 i IT -4
CONTRAtCTOR
4. ADDRESS
PHONE
92.L- 67;2
PHONE
PAI-tCEL NUMBER/5 _
ry
0
Actual Set Backs in Feet
North 'South East (West
Size of Parcel I Zone Classification
ZIP
Typenst.
Occupancy
Sprinklered
❑Yes No ❑ Req'd.
DESIGNER
rJ. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
E (W ❑ ALT. ❑ A ❑ ❑
-/P'N. RPL. MVE.
❑ OTHER
D. ❑ PLMB. LAS MECH. ❑ M.H. ❑ POOL
DESC I E W) t i I I' I U IL
8. II ti� E�`��I �vo
VALUATION SOURCEOGAS ELECTRIC WATER SEWER
9. :,0 UTILITIES
Area of Decks
Finished Basement
Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not 622q'd.
Enum. Dist.
Location (Area)
Ownership
Public ❑ Private
USE CODE
I hereby certify that 1 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 _ J- �/�
DATE OF APPLICATION�� 3-C�i1 �q O l SIGNATURE OF APPLICANT ("}-117 Y� �V LL.��_/�CJ
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plant Examiner
EPA Checklist
ch ian�
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
ICU
17
7
PERMIT NUMBER (”(1'
BkA
02* *1000
* 1 0.00 16
99632
09-29-81
2 6479.
04* * 1 7.00
*17.00 tri
99642
09-29-81
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•9142,
9— '8 9965Z *2.7.00aJ
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL