1980, 11-18 Permit: 80B-3891 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
0...) SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 /1 (d 5-- y/
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
04 * * 7,00
JOB ADDRESS , LEGAL DESCRIPTION - SEE ATTACHED * 7 0 0
LOT BLOCK SUBDIVISION PARCEL^;UMBER/S
2. 389. 0 =
OWNER 7PHONE
ADDRESS ZIP Actual Set Backs in Feet (�,4 7 9,
` �� � /; �n _ l
` - /3 72/ ,i 7.3e-Y, IZ,r /lit ��S.E 9 6,3 7 North !South East West
CONTRACTOR PHONE Size of Parcel Zone Classification
4. tr(1/4.4iLt---
ABWRESS ZIP Type Const. Occupancy Sprinklered
Oyes ❑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.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE KNEW ❑ ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF 0 OTHER -
WORK 0 BLD. 0 PLMB. KMECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
D SCRIBE WORK Enum.Dist. Location (Area)
8. `i_e �� , _ ��/ ` A y ...--g f - FEES COLLECTED
VALUATION SOURCE (cj�ij(S 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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
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 , Plumbing
DATE OF APPLICATION // / Ate-"ge.) SIGNATURE OF APPLICANT -' f ( Mech. /
'
SPECIAL APPROVALS SPECIAL CONDITIONS: /
NAME DATE ✓ Plan Check
Env. Health
SEPA o›-
-
Planning U
- Mobile Home -1
Fire Marshall �.�/�>` % ✓-d -� � J
Co. Engineer /✓ ./".1 Other(Specify)
/;�a s.� / C
Utilities dQ
TOTAL
Plans Examiner WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Buil ingTechr;cian , PERMIT IS NONTRANSFERABLE r} d, O J'
i� 8 ',.'$0 NO. *7,'TOTAL
"� a,- PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL