1980, 09-03 Permit: M80-9504 WoodstovePLAN NUMBER APPLICATION/ PERMIT / PERMIT NUMBER �L
SPOKANE COUNTY - BUILDING C JDES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
`_JOB ADDRESS LECA?L DESCRIPTION — SEE ATTACHED
LOT BLOCK IbUBDI ISIO PARCELNUMErR/S
2.
OWNER PHONE
3. 1�` 1 ' J F,
ADDRESS
ZIP
Actual Set Backs in Feet
/
NorthSouth
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4' ADDRESS
ZIP
Type Con7
Occupancy
Sprinklered
11 i
❑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
Finished Basement
Unfin_ Basement
6.
Baths
No. Stories
No. Rooms
No. of Dwellings
TYPENo.
❑ NEW 1:1 ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
El BLD. ElPLMB. N MECH. ElM.H. 1:1 POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist. Location (Area)
8
FEES COLLECTED
f l {.
VALUATION
SOURCE
S
ELECTRIC
WATER
SEWER
Ownership
USE CODE
_
OF
UTILILITIES
I
Public El Private EJ9.
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
DATE OF APPLICATION � SIGNATURE OF APPLICANT
ech.
SPECIAL APPROVALSI
SPECIAL CONDITIONS:
I-- �
r T
Plan Check
nning
e Marsha
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buiilfling,�ech ician /1
.1C r J ,)(/�-
PERMIT IS NONTRANSFERABLE
DFRIUIT FYPIRFC r)NF VPAR FRr1M HATE r)F ICCIIANrF
SEPA
Mobile Home
04**7.00
7,
* I,00
9503
09-02-80
6.479,
Other (Specify)
TOTAL $ i
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 9 03- 810 9 5 0, 4'z
nATF ISCI 11=n PERMIT Kin
*7.0 0 a0
Tr)TA I