1980, 11-24 Permit: M80B-4201 WoodstovePLAN NUMBER APPLICATION/ PERMIT
!� SPOKANE COUNTY — BUILDING CODES DEPARTMENT
/( NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS 57-- Lr -GAL DESCRIPTION - SEE ATTACHED
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OWNER
PHONE
3. �� / ; ,/—,4 s
4��,p -
ADDRESS
ZIIP?
Actual Set Backs in Feet
—5
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( 9� ��
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
/
I
❑Yes [-]No ❑ Req'd.
LL- 'I <,`,®DSC
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
I
I Upper Floors
Garage Area
I Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
No. Baths
No.
Stories
No. Rooms
No. of Dwellings
TYPE y,�5
1:1 ALT. El AD'N. El RPL. ❑ MVE.
,L'3.NEW
7. OF ❑ OTHER
❑ BLD. ❑ PLMB. IX MECH. ❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
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Enum. Dist. Location (Area)
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
UTILITIES
Public ❑ Private ❑
Single $
1 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. S/E�/E REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
,
nATC nC ADDI 1(`ATInrI �,/ yJ �t, clrNlATi IDC nC ADDI if AhIT 11�E//��q V"/ '- iYY.°'C� � .C/1✓'�
',
Mech.
SPECIAL APPROVALS
NAME DATE
nv. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SPECIAL CONDITIONS:
Plan Check
SEPA
Mobile Home
PERMIT NUMBER
04* *7.00
*7,00 to -
7,
-i
*70061
A *0.00
420,09
1.1 -25-80
z 6479.
Other (Specify)
0J
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
n PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
0
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