1980, 09-04 Permit: 80-9667 Wood Stove\N 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 LEGAL DESCRIPTION — SEE ATTACHED
f 109'1-7 1?6 �N
LOT I BLOCK ISUBDIVISION PARCEL NUMBER/S
OWNER
PHONE
q46•
PERMIT VUMBER
*7,00
*r 0;0 m
9666-'
09-04-80
6479,
ADDRESS
ZIP
Actual Set Backs in Feet
Actual
C, 10,91:7 Z %� /
7y
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5. ADDRESS
ZIP
Main Floor
I Upper Floors
Garage Area
Storage
CHANGE OF USE FROM TO Area of Decks Finished
Basement Unfin. Basement
6. I
TYPE �,/ No. Baths No. Stories
No. Rooms No. of Dwellings
U4 NEW El ALT. 1:1 AD'N. 1:1 RPL. El MVE.
7, OF ❑ OTHER
❑ BLD. ❑ PLMB. MECH. ❑ M.H. ❑ POOL CERTIFICATE
Req'd. Rec'd. Req'd.
WORK
of EXEMPTION
I 71Not
DESCRIBE WORK Enum. Dist. Location (Area)
FEES COLLECTED
8 `C%EJO /Y! 5r
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIESPublic El Private ❑
I
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 lating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTI
Plumbing
�y
DATE OF APPLICATION SIGNATURE OF APPLICANX��T
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Utilities
TOTAL s.7-60 _
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
Buildin Technician PERMIT IS NONTRANSFERABLE
14 0...�A4'�,� l) 0 b z
�'? g Z,40 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
DATE ISSUED PERMIT NO.
*7.0C°F-
TOTAL