1981, 04-08 Permit M81A-3249 Wood StoveF'LHIV IVVNIBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
PERMIT NUMBER
IA ,"47
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESSO V IOi AJ,k
�- I � i'
LOT BLOCK SUBDIVISION
3.
4.
OWR
KNE'I 11M 91J -i
ADDRESS
7004- I el lc
CONTRA
PHONE
2I2-2
3i7
P
PHONE
North
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
'South (East
West
Size of Parcel 1 Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation Building Area in Sq. Ft.
ADDRESS
ZI P
Main Floor
Upper Floors 11 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basemen
Unfin. Basemen
TYPE
7. OF
WORK
NEW ❑ ALT_ D AD N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. 2/MECH. ❑ M.H. ❑ POOL
DESCRIBE WORK
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. 'Location (Area)
Req'd.
VALUATION
9.
SOURCE GAS
OF
UTILITIES
ELECTRIC
WATER
SEWER
Ownersh ip
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
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
17-
TOTAL $ I '
04* *17.00
* 1 7,00
*17.006
A *0.00 0
324,82
04-08-81
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 '4ir 0 S +°81
324'9z- *17.00aPI.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL