1980, 12-23 Permit: 80B-5192 Wood StovePLAN NUMBER APPLICATION/PERMIT
PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
4 k * 7 0 C
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED
t A
71 0
.:5zry
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
I
*%,v0
2.
OWNER PHONE
L14 — \S
A U 0 0 J
3. VAOUSC Of�L tV
ADDRESS ZIP Actual Set Backs in Feet
5 1 C 1 c
�, 0 , ` li North South East West
12-2 3-80
CONTRACTOR PHONE Size of Parcel Zone Classification
sowme
2- 6.479.
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
_ ❑Yes [-]NoElReq'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 I Finished Basement Unfin. Basement
6.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE NEW ❑ALT. El AWN. ❑ RPL. ❑ MVE.
7, OF �/ OTHER . Not
El BILND. ❑ PLMB. MECH. M.H.El POOL CERTIFICATE Req'd. RecdReq'd.
WORK of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area)
FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9, UTILITIES Public ❑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 regulating or the
aconstrn
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION SIGNATURE OF APPLICAN -�` Mech. t C>c�
SPECIAL APPROVALS SPE IAL CONDITIONS:
Plan Check
NAME DATE
Env. Health
SEPA
^-
Planning
c.
—
Mobile Home
w
J
Fire Marshall
—
Co. Engineer Other (Specify)
Utilities
Plans Examiner
cklist
echnician PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
TOTAL $ %` OO
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12i x'2 `3 , 51' 9.2 Z
DATE ISSUED PERMIT NO.
*7,OOCOL ij- -
TOTAL J