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1981, 09-24 Permit: M81A-9742 StovePLAN NUMBER D 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 1. 2. 3. 4. JOB ADDRESS G. C(o l Cv i O rt LEGAL DESCRIPTION - SEE ATTACHED LOT BLOCK SUBDIVISION OWNER ADDRESS E , (4,4,4(v CONTRACTOR nuc - ADDRESS RertE DESIGNER 5. ADDRESS PHONE ZI P tdt-l4 PHONE PARCEL NUMBER/S Actual Set Backs in Feet North !South jEast (West Size of Parcel 1 Zone Classification ZIP Type Const. Occupancy Sprinklered Elves ❑No ❑ Req'd. PHONE Valuation (Building Area in Sq. 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 LYJ NEW ❑ ALT.,,❑AD'N. ❑ RPL. CI MVE. ,% ❑ BLD. ❑ PLMB. LJ MECH. ❑ M.H. ❑ POOL ❑ OTHER No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE WORK 8. i�►JaGtRtil yCire,J1' VALUATION SOURCE GAS I ELECTRIC OF 9. UTILITIES Enum. Dist. I Location (Area) WATER SEWER 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 DATE OF APPLICATION ?e-.5 / SIGNATURE OF APPLICANT SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist Building Technician 7C/V7�1 SPECIAL CONDITIONS: PERMIT IS NONTRANSFERABLE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 0.0e) /r7 PERMIT NUMBER 8I-Q1yr� 04* * 1 7.00 * 1 7.00 U *17,000 A *0,00 97112 09-24-81 6479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 1.019 -2.4'81. PFRMIT FYPIRFS ONF VFAR FROM DOTF OF ISSl1GN17F noTF Icci IFn 974.22 *.17.002 - DCOIIA IT nln T/1TA 1