1980, 09-04 Permit: 80-9558 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
14 8v- 95-s-8
/ SPOKANE COUNTY — BUILDING CODES DEPARTMENT
l./ NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
Q4 * * 7. 00
JOB ADDRESS
F2:9// �UTf/ LEGAL DESCRIPTION - SEE ATTACHED
* 7 -.
LOT BLOCK SUBDIVISION PARCEL NUMBER/S 9557 z
2.
OWNER PHONE
Q9-04-FO
3. ff%,N.evc/J G. .52/"7"Z 2 Z692V-923
ADDRESS ZIP j Actual Set Backs in Feet 647 9,
e.. et5W /O ry 770,0 North 'SouthEast (West
CONTRACTOR PHONE Size of Parcel Zone Classification
S9/?,E
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
/!1f- Dyes DNo ❑ 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
Lf� NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7, OF ,/ ❑ OTHER
WORK
0 BLD. 0 PLMB. LI MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) '
8. � a8 ,P/.J//'U �S'7V OE I FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public 0 Private 0 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.SEES�RREVERSE SIDE FOR REQUIRED INSPECTIONS p� •
�,/ Plumbing
DATE OF APPLICATION 9 4` yo SIGNATURE OF APPLICANT�/i/"'-4 ", )1(44"`� Mech. �I Q�
I
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA
Planning O
_ C-)
Mobile Home w
Fire Marshall
CZ
Co. Engineer Other(Specify)
Utilities
TOTAL $ 7
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Buildin Technician PERMIT IS NONTRANSFERABLE 9 '";Q 4'-•8'0 9 5 5. 8 z I� 0/4 9/y/ PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT •
NO. * TOTAL