1980, 12-23 Permit: 80B-5188 Wood StovePLAN NUMBER PERMIT NUMBER
APPLICATION/PERMIT
N�
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
1.- ��0
LOT BLOCK UBDI I5IUN._. PARCEL NUMBER/S
2.
OWNER PHONE
3. S 4-' A SC r a
ADDRESS
ZIP
Actual Set Backs in Feet
—\ k
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
I
❑Yes [-]No ❑ 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.
I
�NEW
No. Baths
No. Stories
No. Rooms
No. of Dwelling
TYPE?❑ALT. ❑ AD'N. ❑ RPL. MVE.
❑
7, OF ❑ OTHER
WORK ❑ BLD. 1-1PLMB. MECH. ElM.H. F-1POOLCERTIFICATE
Req'd.
Recd.
Not Req'd
of EXEMPTION
DESCRIBE WORK
Enum. Dist. Location (Area)
8. WIc S v6
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
I UTILOITIES
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
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 construction. SEE REVERSE SIDE FOR REQUIRED INSPECS
i
Plumbing
DATE OF APPLICATION I I S-;[rNATURF nF APPI IrONTI
� �
Mech. &00
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
C4* *1,00
1 0
*7,00
518!9-
12-C23-RO
&479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
IY- `0 518.8 21,
DATE ISSUED PERMIT NO.
*700Q�
TOTAL