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1980, 11-03 Permit: 80B-3120 Wood Stove PLAN NUMBER APPLICATION/PERMIT � PERMIT NUMBER SPOKANE COUNTY — BUILDING CODES DEPARTMENT rl — 3i2C, (1), NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES JOB ADDRESS L l * * 7.0 0 1. '67r fc'dl8 /5711 ;LEGAL DESCRIPTION - SEE ATTACHED LOT BLOCK SUBDIVISION PARCEL NUMBER/S 2. 61 1.9z'' OWNER PHONE�y1 1 —•0 3—3 0 3. ReC1( 9A,Z7 S7/9rztc 74 5,6c-79 _ ADDRESS ZIP Actual Set Backs in Feet s (, 7 9 E• /'v/ ! S70" 9?O'37 North 'South East (West CONTRACTOR PHONE Size of Parcel Zone Classification 4. ADDRESS ZIP Type Const. Occupancy Sprinklered /'fti9F Dyes ❑No 0 Req'd. DESIGNER PHONE Valuation Building Area in Sq. Ft. 5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement 6. TYPENo.Baths No. Stories No. Rooms No. of Dwellings D NEW D ALT. �❑(AD'N. 0 RPL. ❑ MVE. 7 WORK 0 BLD. 0 PLMB. rJ MECH. 0 M.H. 0 POOL 0 OTHER CERTIFICATE Req'd. Rec'd. Not Req'd. of EXEMPTION DESCRIBE WORK Enum.Dist. I Location (Area) T FEES COLLECTED 8. t6c10 ace•Rev!I•.+4 S ro LIC I VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE OF 9. UTILITIES Public ❑Private 0 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 local I. regulating construe ion or the performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECT'.• Plumbing DATE OF APPLICATION-51011-60— SIGNATURE OF APPLICANT l • �if W 7 # r Mech. *76' SPECIAL APPROVALS SPECIAL CONDITIONS: NAME DATE Plan Check Env. Health SEPA Planning p J Fire Marshall Mobile Home L Co. Engineer Other (Specify) Utilities �7 TOTAL $ !" Plans Examiner WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist THIS BECOMES A PERMIT. B di Technician PERMIT IS NONTRANSFERABLE 1'11�a. .'i8 0 20 Z *7.0.0 a f/�/7-164c1PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO.51TOTAL