1980, 04-02 Permit M80-3044 Chimney, WoodstovePLAN NUMBER
PERMIT 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
1. 1742'2.
LOT SUBDIVISION
2.
OWNER
BLOCK
3 1 KA-r
ADDRESS I7+ 2.
4.
CON
ADDRESS
f 2 2 { `i ; `fC 7 C1 I
PHONE �
%2 32-0
PHONE
ZI P
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S1 Q 7 �j - 9c''9
6, g6 I o F t.1 lee. r Lott4--I oLc1
Actual Set Backs in Feet
North 'South
East 'West
Size,�jff Parcel Zone Classification
2�e 7G fl /1/4-11';1-') IG
Sprinklered
❑Yes ❑No ❑ Req'd_
Type Const.
Occupancy
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
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
❑ NEW
�J BLD.
R ALT. ❑ AD'N.
❑ PLMB. ❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DES
8. '_1 s2 4 J c)f'{�� , 1_ Ncz 5v
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist.
Ownership
Public ❑ Private
Location (Area)
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^ ,7 n
DATE OF APPLICATION
() SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
-co 1; f- L -� �2 ins . 11.1
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
C)v
04* *7,00
*7,00 In
*7.006
E *0.00
30G,3s
04-02-80
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Iding echnician
PERMIT IS NONTRANSFERABLE
nrr,awlT co nnIC WC A o tonne rinTC AC IQQI IAPII^P
04.-02,-.80t
MATE ICCI IFrI
3044s' *7,COat -
PFRnlIT NC). TOTAL