1980, 12-30 Permit M80B-5327 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
PERMIT NUMBER
fe00-53z7
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
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LOT BLO K
UCfUI V IJIUI I
OWNER
3. R G iME
ADDRESS
6 - C) . _'>+4cic o►.�
• A
CONTRACTOR
4. S.AIMS
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
az,- 2C1
ZIP
PHONE
ZIP
PHONE
ZIP
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North South
East
West
Size of Parcel
Type Const.
Valuation
Main Floor
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area In Sq. Ft.
Upper Floors
Garage Area Storage
Area of Decks
Finished Basement
TYPE
7. OF
WORK
TiNEW 0 ALT. 0 AD N. 0 RPL. ❑ MVE,
❑ BLD. ❑ PLMB. VMECH. 0 M.H. ❑ POOL
0 OTHER
No. Baths No. Stories
CERTIFICATE
of EXEMPTION
Unfln. Basement
No. Rooms
Req'd.
DESCRIBE WORK
8.!*.it1z1VLN
VALUATION SOURCE
OF
9. UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist.
Location (Area)
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 f a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulng construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO S
DATE OF APPLICATION
22 r—
Jli SIGNATURE OF APPLICAN
Leheryb
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. + C.2
Plan Check
SEPA
Mobile Home —
Other (Specify)
TOTAL $ Z xi
04* *7.00
*7.00
*7.006
A *0.00
532,6.g
12-30-80
g 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Buildin
9
Technician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
;12 75:9`t'1101
DATE ISSUED
5'3O. .27z 4.7,~00
PERMIT NO. TOTAL