1981, 10-01 Permit: 81B-122 Wood StovePLAN APPLICATION/ PERMIT
PERMIT NUMBER
NUMBER
�a � , ��
V
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
4 * * 1 7,00
LOT BLOCK UBDIVISION PARCEL NUMBER/S
2,
* 1 7,00
OWNER PHONE
A * 0 0 :0 _.
CtAC C:,-cC-A-- K t �lua �Xi �= \� �:
3.
ADDRESS ZIP Actual Set Backs in Feet
n
1 G 1
G . II7-']-C� �' - North South East West
CONTRACTOR PHONE Size of Parcel Zone Classification
b. 4 7 9.
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 I Finished Basement Unfin. Basement
s.
No. Baths No. Stories No. Rooms No. of Dwellings
�/
TYPE lJ NEW ❑ALT. El AD'N. ❑ RPL. El MVE.
% Req'd. Recd. Not Req'd.
❑ BLD. ❑OF
PLMB. (�/MECH. ❑ M.H. ❑ POOL OTHER CERTIFICATE
4
WORK
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area)
FEES COLLECTED
8. 'll Ir �i`> L i AQ.0v.
VALUATION SOL,RCE GAS ELECTRIC WATER SEWER Ownership USE CODE
9, 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
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 construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
10 �— S)
DATE OF APPLICATION - SIGNATURE OF APPLICANT Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities
Plans Examiner
cian PERMIT IS NONTRANSFERABLE
-�7• PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
TOTAL $ I—? • ce—,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12 2 Z`.
DATE ISSUED PERMIT NO.
TOTAL