1980, 01-11 Permit: 80-95 Wood Stove PLAN NUMBER APPLICATION/PERMITM PERMIT NUMBER I
SPOKANE COUNTY - BUILDING CODES DEPARTMENT /- ' ,-�J-- g5
NORTH 811 JEFFERSON /*SFOKZ E,WASHINGTON 99260 / (509) 456-3675 DATE / `"l/'$d
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES C * * 7,0 0
JOB ADDRESS * ', 0 N
/,�/ JO LEGAL DESCRIPTION — SEE ATTACHED
1 LOT 'BLOC� 'VISION PARCEL NUMBER/S * 7.0
2. n o
KVPHONE E * 0 0 0 U
3. ails r-ed el rJ-' 9, 4 2
ADDRESS ZIPy �i Required Set Backs in Feet
4 A
J/.'/ ad,a�z - / 9 2a North 'SouthEast (West 0 1 — 1 1 —8 0
C9.�VTRACTO / PHONE Size of Parcel Zone Classification
4 ,F, A C -Ct [tet a.4/d 14.1- ier 6-Z.'4.-‘ 9.7,5.- 2 6.4 7 9,
ADDRESS {/ p ZIP Type Const. Occupancy Sprinklered
%, J a f &f,i7)fl. XI 044.-C,., g ei'• --.s-3 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
rJ. 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 ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. Xi MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DE CRIBE WORK
8. 1 ,.44 -d—� �� , �GL�. /..d ,1-� FEES COLLECTED
VALUATION ource GASELECTRIC 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 I cal aw re8ul�g cons u ion or the
performance of construction. /// Plumbing
DATE 1 -ii- PJ SIGNATURE ,-C' ('
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health cc
SEPA o
Planning — w
0..
Mobile Home
Fire Marshall z
Co. Engineer Other (Specify)
Utilities dei
TOTAL $ 7
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist ? THIS BECOMES A PERMIT.
DATE OFFICIAI ` i __'� -�
APPROVED FOR ISSUANCE —