1980, 11-06 Permit: M80B-3306 Stove...MBER
APPLICATIONi 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.
JOB ADDRESS
e iV6/5 /8Th'
LEGAL DESCR/'PTR)r - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWNER
Y/f <&i'/urCe
ADDRESS
/5/6.s- /8'rn
CONTRACTOR
4. ADDRESS
PHONE
9Z4 -S3S2
ZI P
9737
Actual Set Backs in Feet
North 'South (East 'West
PHONE
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Eyes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation 1Building Area in Sq. Ft.
ZIP
Main Floor ` Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.,❑ AD'N. ❑ RPL. ❑ MVE.
❑ PLMB. L►1 MECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. k e:0434/7/11/,..1) .SYa d er
(VALUATION
9 ,Soo. oa
SOURCE GAS
OF
UTILITIES
Enum. Dist.
ILocation (Area)
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private ❑
USE CODE
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
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
/ //JA8c.
SIGNATURE OF APPLICANT ,•e-ik.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
4 Buildinghnician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building -$ /0- .)17e)
Plumbingi
Mech. 7.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $i/7rCX'
PERMIT NUMBER
Boa •-33o6
02* *1000
* 1000 V)
* 10006
A *000 8
330.48
11=06-80
z 6479:
04* *700
*7:00
*7006 -
A *000
330,52
11-06-80
2 6479:
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
111-167'80
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSIIFn
33a6g *1:7.00
PFRMIT NO Tr1TAI
L