HomeMy WebLinkAbout1982, 10-06 Permit M82A-9136 Woodstove(PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
PERMIT NUMBER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT BLOCK SUBDIVISION
OWNER
3.I�fl' /G`'►2�_`
ADDRESS
CONTRACTO II
4. ADDRESS
i
PHONE
lZ-P LJ
PHONE
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
TO
ZIP
PHONE
ZIP
12 NEW ❑ ALT. ❑, AAD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. EMECH. ❑ M.H. ❑ POOL
❑ OTHER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs In Feet
North (South
Size of Parcel
East 'West
Zone Classification
Type Const. Occupancy
Valuation
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Main Floor Upper Floors Garage Area
Storage
Area of Decks
No. Baths
Finished Basement Unfin. Basement
No. Stories I No. Rooms INo. of Dwellings
CERTIFICATE
of EXEMPTION
Location (Area)
DESCRIBE WORK `,
8. (%�i C'�� V
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist.
Req'd. Rec'd. Not Req'd.
Ownership
Public ❑ Private 0
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 INSPECTIO
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ —Z- C9
04* *20.00
*20.006
A *0,00
913.52
10.06-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
f
1 O.L 0 '6 -.8' 2
DATE ISSUED
9'13.6g *20.002 —
PERMIT NO. TOTAL