1980, 12-01 Permit: 80B-4309 Wood Stove PLAN NUMBER I APPLICATION/PERMIT a A IPERMI`NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT jl � � -W
0.0// NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
v APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS l 4 * * 7 0
1.• Ce:: 111og�� �{ r� . � LEGAL DESCRIPTION - SEE ATTACHED �,
*7. 0G
LdT 1 BLOCK SUBDIVIS O PARCEL NUMBER/S
2. I 4308
OWNE �'' PHONE 1 2-01 -80
3. (611:4_ .tire-f' q,-e-,5 d Z.7
ADDRESSZIP/ Actual Set Backs in Feet " 6 4 7 9,
c /e) / ;,2,2-pL (-6)
_s , 1/ , ',.iii_ 9 7 ..O North 'SouthEast (West
CONTRACTOR PHONE Size of Parcel Zone Classification
4. - DRESS ZIP Type Const. Occupancy Sprinklered
y ..r.� .. Dyes ❑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.
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
❑ NEW 0 ALT. 0 AD'N. 0 RPL. ❑ MVE.
7. OF 0 OTHER -
WORK 0 BLD. 0 PLMB. MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DERIBRt . Enum.Dist. I Location (Area) r FEES COLLECTED
8. CyG,L, x1r4-7)-L
VALUATION SOURCE GAS f ELECTRIC WATER SEWER Ownership USE CODE
OF
9. -- UTILITIES Public ❑Private ❑
Single $ 4
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 c Plumbing
-
7
DATE OF APPLICATION /-Z- '/—e e) SIGNATURE OF APPLICANT -4--/--1...... Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA >
Planning O
e.)
Mobile Home w
Fire Marshall -a
%i
Co. Engineer Other(Specify)
Utilities aU
TOTAL $ 7
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Bui ing-cech cian PERMIT IS NONTRANSFERABLE I
-- //ll ��J�;- l'�1-�8,} -$'0 43Q9Z. *7,0:0a �
j/.LY4J o(a.A,i- �1 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL