1983, 10-03 Permit: 83A-9814 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
JOB ADDRESS
LEGAL DESCRIPTION -SEE ATTACHED
LOT I BLUCK ISUBDIVISION I PARCEL NUMBER/ -S
OWNER / PHONE
3. l/-- 15( ff *17 ( i M Cl�� -I—
ADDRESS ZIP Actual Set Backs in Feet
North South East
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
n PERMIT IS NONTRANSFERABLE
�— PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Mobile Home
Other (Specify)
/) r
TOTAL $
U nGC 0C) -
* 2: 110
A
7 C-[�Z-�3
4 l 7 9
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1'0=0'5-8'5 9'8L4,2
DATE ISSUED PERMIT NO.
*20.00
TOTAL
CO�TRACTOP
O
Size of Parcel
Zone Classification
4'
I SOURCE
GAS
r
SEWER
Ownership
USE CODE
9.
ADR
I
Public❑Private ❑
Type Const.
Occupancy
Sprinklered
l
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
❑Yes ❑No ❑ Req'd.
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
DESIGNER
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
PHONE
Valuation
Building Area in Sq. Ft.
5.
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
Plan Check
ADDRESS
ZIP
Main Floor I
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
TYPE ❑ NEW
I–] ALT.
ElAD'N. 11 RPL.
❑ MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwellir
7,
OF
❑ OTHER
WORK ❑ BLD.
❑ PLMB.
❑ MECH. ❑ M.H.
❑ POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'
of EXEMPTION
I
DESCRIBE WORK
8 �,
c
Enum. Dist.
Location (Area) FEES COLLECTED
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
n PERMIT IS NONTRANSFERABLE
�— PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Mobile Home
Other (Specify)
/) r
TOTAL $
U nGC 0C) -
* 2: 110
A
7 C-[�Z-�3
4 l 7 9
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1'0=0'5-8'5 9'8L4,2
DATE ISSUED PERMIT NO.
*20.00
TOTAL
VALUATfON
I SOURCE
GAS
ELECTRIC WATER
SEWER
Ownership
USE CODE
9.
OF
UTILITIES
I
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 INSPECTIONS
Plumbing
DATE OF APPLICATION SIGNATURE OF APPLICANT
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
n PERMIT IS NONTRANSFERABLE
�— PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Mobile Home
Other (Specify)
/) r
TOTAL $
U nGC 0C) -
* 2: 110
A
7 C-[�Z-�3
4 l 7 9
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1'0=0'5-8'5 9'8L4,2
DATE ISSUED PERMIT NO.
*20.00
TOTAL