1980, 01-15 Permit: 80-277 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 4 COPIES
`JOB ADDRESS
t `Dr /096 7 SU/6 tri
B OCK
2.
3. PM,
ADDRESS
E /a 90 7 /0,s1,12,,i-e.
CONTRACTOR
n ru e,
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
PHONE
9a&—/*7?
ZIP
992060
PHONE
Required Set Backs in Feet
North [South
East 'West
Size of Parcel Zone Classif Ica tion
ADN R ESS
ZIP
Type Const.
Occupancy Sprinklered
Dyes ENO ❑ Req'd.
5
DESIGNER
PHONE
Valuation
Budding Area i Sq Ft.
ADDRESS
ZIP
OWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Spht Entry
Split Level
Rancher
TYPE
7, OF
WORK
❑ NEW
❑ BLD,
❑ ALT. ❑ AD N.
❑ PLMB. MECH.
0 RPL,
❑ MVE,
❑ POOL
0 OTHER
No. Baths
No. Floors
NO. Rooms
RecRoom
CERTIFICATE
of EXEMPTION
Req'd.
Not Req'd.
ESCRIBE WORK
VALUATION g 01 GAS �� E ,IC WATER
9. utilities
SEWER
I hereby certify that I have re d and examined this application and have read the '
on reverse side, and know the same to b true and correct. All provisions of laws
type of work will be complied with whe her specified her in or not. The granting
to give authority to violate or cancel the -provisions of any other state or local law
performance of construction,
DATE / —/G - SIGNATURE
'NOTICE" provisions included
and ordinances governing this
of a permit does not presume
regulating construction or the
SPECIAL APPROVALS
DEPT.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE OFEICIA�' ^^�
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
to -
PERMIT NUMBER
N So -277
DATE/
14*
;1-15—.0
6 [I 7 c
WHEN MACHINE VALIDATED IN THIS SPACE.
THIS BECOMES A PERMIT.