1980, 02-14 Permit 80-1196 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
• 3 S FLORA
11
LOT BLOCK
2.
OWNER
3. G c'aP_G ADAS 15
ADDRESS
J UI3LJI V IJI'JIN
4. ADDRESS
N L 3514) 'FLORA
CONTRACTOR
Sf�C
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
NEW
D BLD.
DESCRIBE WORK
D ALT.
❑ PLMB.
❑ AD'N.
tiMECH:
8. 1s \14oD STOue-
VALUATION
9.
Source
of
Utilities
❑ RPL.
❑ M.H.
GAS
PHONE
qzQ--(f`c `74
ZIP
C16(
PHONE
ZIP
PHONE
ZIP
❑ MVE.
❑ POOL
0 OTHER
ELECTRIC
LEGAL DES�.RIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
Size of Parcel
East
West
Zone Classification
Type Const.
Occupancy Sprinklered
DYes ❑No ❑ Req'd.
DWL Area
Split Entry
WATER
Basement Area
SEWER
Buil
ding Iding Area in Sq. Ft.
Garage Area
Split Level
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.
DATE X ) i'% $ 6
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE 410_ OFFICIAL L 7
Storage
Rancher
Rec. Room
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. �7.00
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ —7•60
PERMIT NUMBER
DATE z//'// o
04*
*7,00
*7,00
119,52
02- 1 4'-80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B,ECOMESA PERMIT.
0 2)-1' 4 i= �8. 0' 119, 6
* 7. 0 0 a I —
APPROVED 0 ISSUANCE