1980, 01-02 Permit: 80A-9693 Wood Stove PLAN NUMBER APPLICATION/PERMIT
PERMIT N MBER I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT n ge4g�
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /V---3/ —7
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS 0 4 * *7'hi 0
1. c.--( lig t444r ,LEG/ DESCRIPTION — SEE ATTACHED * 7
LOT I BLOCK SUBDIVISION PARCEL NUMBER/S
2 I 969, 2-2
OWNER PHONE
3. L At.�QC-'NCO' E. Be.06 ..S 535=3t GI 0 1 —0 2— 0
ADDRESS �.A t ZIP Required Set Backs in Feet :26 4 7 9.
art lS 6 1441' gci206, North 'SouthEast (West
CONTRACTOR PHONE Size of Parcel Zone Classification
SJ71
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE [1 NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER —
WORK CIBLD. CIPLMB. Ql MECH: CIM.H. CI POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
/ of EXEMPTION
DESCRIBE WORK
8. 1NS Ac.Z M3c'cD s(OUC FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities 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 to al law regulating construction the
perfor a ce of construction. / Plumbing
odeor
DATE J9
. C3/ � f/ / SIGNATU F. .L iA ` _ L _Rii& Mech. >51 7fi0
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA o
Planning U
w
a_
Fire Marshall Mobile Home
Z
Co. Engineer Other (Specify)
Utilities
TOTAL $ 7•O U O
Zone Clearance
�(� + WHEN MACHINE VALIDATED IN THIS SPACE,
/n'�T' � THIS BECOMES A PERMIT.
SEPA Checklist ����/���� � n ✓ � .� U 7 ��: n ' 4 i) Z ( *, i � ^, _;
DATE OFFICIAL
U i L 43 U- U 2 G 7, c. U 0.. F
APPROVED FOR ISSUANCE _