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