1980, 07-02 Permit M80-6602 Fireplace w Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
PERMIT NUMBER
80''r o?
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
/ee/S //I/0//9i7ir9
LOT B OCK
JUtlUI V IJIUIN
OWNER
3
ADDRESS
C . /82.''S ieva/.?,vy
CONTRACTOR
4. ADDRESS
PHONE
ZIP
9gd/a
PHONE
DESIGNER
rJ. ADDRESS
ZIP
PHONE
CHANGE OF USE FROM
6.
TO
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South East 'West
Size of Parcel
Zone Classification
Type Const.
Occupancy
Valuation
Sprinklered
❑Yes ❑No D Req'd.
Building Area In Sq. Ft.
Main Floor Upper Floors Garage Area
Storage
Area of Decks
Finished Basement
Unfln. Basement
TYPE
7. OF
WORK
P NEW 0 ALT. ,❑�(AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. CJ MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths 1 No. Stories
CERTIFICATE
of EXEMPTION
No. Rooms INo. of Dwellings
Req'd. Rec'd. Not Req'd.
DESCRIBE WORK
8. 04 nfo
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
w woo,o 3rov--
ELECTRIC
WATER
SEWER
Enum. Dist. Location (Area)
Ownership
Public ❑ Private 0
USE CODE
I hereby certify that 1 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 gulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION
6 SIGNATURE OF APPLICANT
SPECIAL APPROV L
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
PECIAL CONDITIONS:
76 /etc thn, s race Cr''v //4' /1 e.7/2a/9✓✓
rn' 6Y1,96.o v# Y /iv Sr/ Tcfre Avne-,e / -,?S
7ee4,tl cfaeeClaa
FEES COLLECTED
Single $
Building
Plumbing
Mech. f>'''7^C9d
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ Cr)
04*
*7.00
*7.00 i
660,12
07-02-80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Bu din`Technician
F f 1/2/A'
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
0 0,--I 0"2.) ' 8:0
DATE ISSUED
660.26 *7,00°.I
PERMIT NO. TOTAL