1981, 01-14 Permit: 81A-490 Wood Stove PLAN NUMBER APPLICATION/PERMITPERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT ti 8 Li\-4{O
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS �� 0 4 * * 1 7.0 C
1. � , It2(Q 23RD LEGAL DESCRIPTION — SEE ATTACHED
;kr/ 0c `
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. ____ (�- { 9
OWNER PHONE
3. C - 1Arec.�5 E , C..N ccze-4Act 4 0 1 — 1 4—8 1
ADDRESS (ZII,P/, Actual Set Backs in Feet 7
E . It 2'4 23tizD Feet- -dCo North 'South East IWest
CONTRACTOR PHONE Size of Parcel Zone Classification
4. ADD EESS ZIP Type Const. Occupancy Sprinklered
,hl6 Oyes ❑No 0 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 1 No.Baths No. Stories No. Rooms No. of Dwellings
KJ NEW 0 ALT. 0 AD'N. 0 RPL. ❑ MVE.
7. OF 0 OTHER
WORK 0 BLD. 0 PLMB. EIMECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) FEES COLLECTED
8. ( '0C3(.l.(Zn.)t A.)C\ S t)QC I
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public ❑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
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 constructii SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION `-- rte-42e SIGNATURE OF APPLICANT /— '' s— Mech. 4 17.coo
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA n_
-)
Planning ,_7
Fire Marshall Mobile Home I
Co. Engineer Other(Specify)
Utilities
TOTAL $ IZ e00
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
uildi Technician PERMIT IS NONTRANSFERABLEt j 1! A 9 —
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT N