HomeMy WebLinkAbout1980, 01-03 Permit: 80A-9765 Wood StovePLAN NUMBER APPLICATION/ PERMIT //�/I , A PERMIT NUMBER `
SPOKANE COUNTY — BUILDING CODES DEPARTMENT �� u�
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE —5'/1
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
LEGAL DESCRIPTION -SEE ATTACHED
LOT I BLOCK ISUBUIVISION I PARCEL NUMBER/S
3
OW ER
A R ESS
Required Set Backs in Feet
North South East West
Size of Parcel
Zone Classification/s
COCO TRACTOF
4'
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
AD RESS
DWL Area
Basement Area
Garage Area
DESIGNER
5.
Split Level
Rancher
ADDRESS
CHANGE QP7,USE FROM
6.
PHONE
Z II PP ,
PHONE
ZIP
PHONE
ZIP
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 OF WORK 1:1BLD. ❑ PLMB. JAI MECH: ElM.H. ❑ POOL ❑ OTHER
RIB E WORKI
Add 4
/A
VALUATION
�, �I
q / '7 6;, 6
Required Set Backs in Feet
North South East West
Size of Parcel
Zone Classification/s
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
DWL Area
Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
FEES COLLECTED
VALUATION
Source
GAS
fELECTRIC
WATER
SEWER
of
9, —
Utilities
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
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 ocal law regulating construction or the
performance of construction.
Plumbing
S -
SIGNATURE
Mech.DATE
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ -D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
TOTAL $,_
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
SEPA Checklist
DATE 0FFICIAL,
�'�
01,-03-�G X76.5
APPROVED FOR ISSUANCE
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