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1981, 10-02 Permit M81B-0160 Wood StovePLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT rPERMIT NUMBER v 1 7 - 0 16,o NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES 1. 2. 3. 4. JOB f�DDR4S9 I� I ' + _Ifs . LOT BLOCK IL{��j�! 1? Z W ONE OWNER iiN1� \'/ti - � ADDF ESS 13 jSte,} (O E ) -(2- PHONE LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S Actual Set Backs in Feet North 'South lEast (West Size of Parcel I Zone Classification ADDRESS ZIP Type Const. Occupancy Sprinklered Elves ❑No ❑ Req'd. DESIGNER 5' ADDRESS PHONE Valuation Building Area in Sq. Ft. ZIP Main Floor Upper Floors 1 Garage Area Storage CHANGE OF USE FROM 6. TYPE 7, OF WORK TO EKNEW ❑ ALT. D;AD_'N. ❑ RPL. ❑ MVE. D BLD. ElPLMB. Ld MECH. ❑ M.H. ❑ POOL DESCRII3E WORK 8. 1.44 cic.W OTHER Area of Decks No. Baths Finished Basement No. Stories No. Rooms Unfin. Basement No. of Dwellings CERTIFICATE of EXEMPTION Enum. Dist. I Location (Area) Req'd. VALUATION 9. SOURCE OF UTILITIES GAS ELECTRIC WATER SEWER Ownership 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 INSPECTION DATE OF APPLICATION /0 L SIGNATURE OF APPLICANT SPECIAL APPROVALS SPECIAL CONDITIONS: NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist Rec'd. Not Req'd. FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) 17, TOTAL $ 1.7 ' 0L * * 1 7,00 *17.00 * 1 7.006 A *000 159 '10-02-81 2 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE �O02'-8`l 16.0g DATE ISSUED PERMIT NO. *17,OOaiJ- TOTAL 1 0 • Zo/ /a /3(oc../•<. wd.e-146‘ / ,2 ,y NA igf. /75- Lc'rf2 .1 52N //APT COIM7: ol / 3