1985, 01-27 Permit M81A-6520 StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
PERMIT NUMBER
,'A030
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
•
LOT BLO K
2
OWNER
3.
ADDRESS
CONTRACTOR
4. ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
SUBDIVISION
ZIP
PHONE
ZIP
TO
❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE.
0 PLMB. 'RI/MECH. ❑ M.H. 0 POOL
0 OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER'S
Actual Set Backs in Feet
North South East
Size of Parcel Zone
West
Classification
Type Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Main Floor I Upper Floors
Building Area in Sq. Ft.
Garage Area
Storage
Area of Decks
Finished Basement
Unfin. Basement
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
DESC BE W\ORK Enum. Dist.
No. Rooms
No. of Dwellings
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 INSPECTIONS
DATE OF APPLICATION k"---Ct-M \"\
SIGNATURE OF APPLICANT ' .�
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. `!
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
/7
04* *17,00
* 1 7,00 r
* 1 7.006
A *0.00
651,92
06-30-81
1.2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
6,_ I5 a_ 81;
DATE ISSUED
6520z *'17.000
I-
PERMIT NO. TOTAL