1980, 05-02 Permit: 80-4271 Wood Stove •
PLAN NUMBER f APPLICATION/PERMIT PERMIT NUMBER
80
SPOKANE COUNTY — BUILDING CODES DEPARTMENT .4`z-71-
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED ` 4
1. G. it-Roolbw .p * 600 7,
LOT BLOCK SUBDIVISION PARCEL NUMBER/S *6 0 O U
2.
OWNER PHONE E *. Q U 0 E
3. --S.If% Et-rc►c C{Z/O—ctZGC.
ADDRESS ZIP Actual Set Backs in Feet 4 2 6 9
G. rr1t V LLT AVE qCliZU4 North 'South East 'West 0 5-0 2- 0
CONTRACTOR PHONE Size of Parcel Zone Classification
4. SA►vr- 6 7 9,
ADDRESS ZIP Type Const. Occupancy Sprinklered
SAmE ❑Yes ❑No ❑ Req'd. 0 4 * * 1.Q Q
DESIGNER PHONE Valuation Building Area in Sq. Ft. * 1.0 0
ro
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage 4 2 7, 0 -
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement 0 5- Q 2-8 0
6. 5 6479.
TYPE / No. Baths No. Stories No. Rooms No. of Dwellings
LvJ NEW D ALT. D AD'N. 0 RPL. 0 MVE.
7, OF 0 OTHER
WORK
0 BLD. 0 PLMB. Er MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) 1
FEES COLLECTED
8- INS-CACI— ILAIOC)U `$uR_n;INCt ScCcv e
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership z USE CODE
OF Public 0 Private
9. UTILITIESSingle $
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 granti.• • . permit does not presume Building
to give authority to violate or cancel the provisions of any other state or lo•. law regul. ing construction or th-
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONSAM, Plumbing
C._
DATE OF APPLICATI SIGNATURE OF APPLICANT /� �•* — Mech. -T.Ocli
SPECIAL APPROVALS SP CIAL CONDITIONS:
NAME DATE // Plan Check
Env. Health
SEPA n
Planning
cj
Fire Marshall Mobile Home ._I
U-.
Co. Engineer Other(Specify)
Utilities
TOTAL $x•00
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
•
Bui3/eJ
' g Technician PERMIT IS NONTRANSFERABLE Ji �U 2.`-� �, y �, I *�. O O.°
�I• S �'d PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL