1981, 10-20 Permit: 81B-905 Wood Stove PLAN NUMBER APPLICATION/PERMIT
PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT M /4 9e7,C-
V NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
my
JOB ADDRESS
1. E. 11213 17th Avenue LEGAL DESCRIPTION — SEE ATTACHED 0 4 * * 1 7. 0C
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 17 C 0 s"-
2. * 17001`
OWNER PHONE
3. LEONTINA I,ASI�EY 924"1459 ,'. * 0 C, 0
ADDRESS ZIP Actual Set Backs in Feet
Sarre 99206 North 'SouthEast 'West 9 C. !!
CONTRACTOR PHONE Size of Parcel Zone Classification
1
4. SAME l 'v-20- x'
ADDRESS ZIP Type Const. Occupancy Sprinklered 6 Q 79
❑Yes ❑No ❑ 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.
TYPE No. Baths No. Stories No. Rooms No. of Dwellings
KNEW ❑ ALT. ❑ AD'N. 0 RPL. ❑ MVE.
7, OF ❑ OTHER
WORK 0 BL CIPLMB. EXMECH. 0 M.H. ElPOOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) FEES COLLECTED
8. WOOD STOVE
VALUATION SOURCE GAS ELECTRIC WATER SEWER
OF Ownership USE CODE
9. UTILITIES Public ID Private ❑
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 law regulating construction or the
performance of construction.SEE REVERSE
SIDE FOR REQUIRED INSPECTIONS �/yJ Plumbing
DATE OF APPLICATION 1'yat- / l/ g� SIGNATURE OF APPLICANT � �� L� '�/1/ ech. 17.00
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA n
Planning CD
C.)
Fire Marshall Mobile Home -�
Li:
Co. Engineer Other(Specify)
Utilities
TOTAL $ 17,00
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building Technician PERMIT IS NONTRANSFERABLE 1'0;t!'.2 0 -'8 1 9 0.5 °z *1 T0 0 a Pi
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL