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1981, 01-20 Permit App: 81A-691 Wood StoveSPOKANE 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 1 -P -141,17L"'4 L EGArL DESCRIPTION — SEE ATTACHED LOT I BLOCK ISUBDIVISION I PARCEL NUMBER/S NER aw� PHONE ADDRESS Q ZIP Actual Set Backs in Feet Env. Health `North Fire Marshall South East West CONTRACTOR PHONE Size of Parcel Zone Classification 4' AD,YRESS ZIP Type Con;Fj Occupancy Sprinklered Oyes ❑No ❑ Req'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 Finished Basement Unfin. Basement 6. TYPE El NEW El ALT. El AD'N. El RPL. El MVE. No. Baths No. Stories No. Rooms No. of Dwelling 7, OF El OTHER n��1I WORK El BLD. 1-1) PLMB. MECH. ❑ M. H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd of EXEMPTION DE CRIBE WORK Enum. Dist. Location (Area) 8. FEES COLLECTED VALUATION SOURCE G AfS ELECTRIC WATER SEWER Ownership USE CODE 9. I UTILOITIES I Public El 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 'A( DATE OF APPLICATION -' f� —�� SIGNATURE OF APPLICANT Mech. SPECIAL APPROVALS NAME DATE SPECIAL CONDITIONS: Plan Check SEPA Mobile Home Other (Specify) TOTAL WHEN MACHINE VALIDATED THIS BECOMES A PERMIT. Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner IN THI SEPA Checklist /II is -&9/ 04* * 1 7.00 *1700 to 69.'0 01-20-81 22 6,479, I ng Tec nicia PERMIT IS NONTRANSFERABLE 6 9. 1 z PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. 17.00°,1 -- TOTAL