1980, 09-29 Permit: 80B-1100 Wood StovePLAN 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 ADDRESjjS
1.
�OCK UBD151'?/" 0
2.
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
3.
ADDRESS
CONTRACTOR
4. ,C2-4,241,
DRESS
fa`141,
DESIGNER
5. ADDRESS
PHONE
ZIP
te` 7
�7 4,71
Actual Set Backs in Feet
North 'South
East
'West
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
O PLMB.
0 AD N.
;K1 MECH.
❑ RPL.
O M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
-
VALUATIO SOURCE
OF
9. UTILITIES
/ J
-h
GAS ELECTRIC
Enum. Dist.
Location (Area)
WA'rE R
SEWER
Ownership
Public ❑ Private ❑
USE CODE
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
to give authority to violate or cancel the provisions of any other state or local law regulating ction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS, 1 ` n
DATE OF APPLICATION 9 ',=zy -ZJ SIGNATURE OF APPLICANTi' /"V` i iC�V�/tLLS 5? f Mech.
FEES COLLECTED
Single $
Building
Plumbing
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Techcician,)
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
8d/3 --//40
(j 4 * *7,00
* i, 0 0 L
*7,00u
A *0.00 (t?
1 09.9,2
09-29-80
6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09-2'9-80 lI0,0
DATE ISSUED PERMIT NO. TOTAL
*7.00° -