1982, 09-13 Permit M82A-8203 Wood StoveNUMBER
APPLICATION/PERMIT
SPOKANE COUNTY = BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
4. ACLDI.IE
LOT BLOCK SUBDIVISION
4.
ADDREL
CONTRACTOR
PHONE
o
Z P
q,b
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 1South East West
Size of Parcel Zone Classification
ADDRESS
�gMic
ZIP
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5.
ADDRESS
PHONE
Valuation Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
00 NEW ❑ ALT. D AD'N./El RPL. ❑ MVE.
El BLD. ❑ PLMB. LY MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. CA-)cao+vc, c-rind&-.
VALUATION SOURCE GAS ELECTRIC
OF
9. UTILITIES
WATER
SEWER
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
I 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
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
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SIGNATURE OF APPLICAN
SPECIAL CONDITIONS:
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
82A-- SI°3
L;4* *20.00
*20.006
A *0.00 ES
82022
09-13-82
2 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
irchni���n
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
0`9-1'3-0 820.3z *2'0.000
DATE ISSUED PERMIT NO. TOTAL
/2Q