1980, 10-01 Permit: 80B-1232 Wood StoveNUMBER APPLICATION/ PERMIT
n� SPOKANE COUNTY — BUILDING CODES DEPARTMENT
1 - NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1681---o 3 T5 LEGAL£OES0111PTION — SEE ATTACHED
LOT I BLOCK ISUBDIVISION PARCEL NUMBER/S
2.
OWNER PHONE
3. ./4C FR/3 .v 9 S'i5r
ADDRESS
ZIP
Actual Set Backs in Feet
/bsleo
9gZ0
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
15
SEPA
O
4. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Mobile Home
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
Co. Engineer
ADDRESS
ZIP
Main Floor
I Upper Floors
Garage Area
I Storage
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
Buildin Technician
- « ,
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
DATE ISSUED PERMIT NO.
TYPENo.
Baths
No. Stories
No. Rooms
No. of Dwelling
NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF I ❑ OTHER
❑ BLD. ❑ PLMB. Ili MECH. ❑ M.H. POOL
VIM
CERTIFICATE
Req'd.
Rec'd.
Not Req'd
WORK
of EXEMPTION
I
DESCRIBE WORK
Enum. Dist. Location (Area)
I
FEES COLLECTED
8. lc� .O
.Pint
.57'o v
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
I UTILITIES
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
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 la
regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
Plumbing
nATF r1F APPI ICATIr1N ��:/ dH6 CI(;NATI IRF nP APPI ICAKIT
�/
"Cy
'�r���
Mech. i—7j:2C1
PEjRRM`IT NUMBER -y
04* *7.00
*7.00
1 23.1 7'-
10-01-80 10-01-80
6479:
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
SEPA
O
Planning
Mobile Home
w
J
Fire Marshall
Other (Specify)
- ,
TOTAL $
Co. Engineer
Utilities
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
SEPA Checklist
PERMIT IS NONTRANSFERABLE
�' 8' 1 2 3, 2
I a � a' `r— a
* %, o a a -
Buildin Technician
- « ,
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
DATE ISSUED PERMIT NO.
TOTAL