1981, 11-20 Permit M81B-2025 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 3 COPIES
JOB ADDRESS
iS i �1 E 1SUBDI nri a uct, � ;�c�eG�LOT BLOCK ISION
OWNER pp i `
3. . Pc t .IY rl ik r 6. L . LO(,K at-t`d
ADDRESS
Sir i i= T. p-,ck tcwu„(•x,y,F 4hc
CONTRACTOR
4. ADDRESS
PHONE
ZIP
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South [East (West
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Oyes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation (Building Area in Sq. Ft.
ADDRESS
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
CJ NEW
❑ BLD.
0 ALT. ❑AD'N. ElRPL. ❑ MVE.
❑ PLMB. CJfMECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIBE WORK ��
8. Lk' cY')c SK�UC..
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
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 pp �J
DATE OF APPLICATION,X (1 — 1 ci `gyp I SIGNATURE OF APPLICANT (.A.GG)..a. � ,1\011-4411C
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. 0.00
Plan Check
SEPA
Mobile Home -
Other (Specify)
TOTAL
$
PERMIT NUMBER
04* *17.00
*1700 N
*17006
A *000
2024�
1 ,1 -20-81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•ng hnician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Pi _ 0 81,
DATE ISSUED
20255 *17.0Oae_ -
PERMIT NO.
TOTAL