1980, 09-23 Permit M80B-682 Wood Stove, ChimneyPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
r/
PERMIT NUMBER
&)-
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT
E-/"77/9 ae.C24,17 IeV1fy
BLOCK SUBDIVISION
OWNER
3. CG pe K -7242.9, 6 Eft
4.
ADDRESS
ter- i77 f 9
CONTRACTOR
ADDRESS
DESIGNER
J. ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
PHONE
ZIP
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North
South
East
Size of Parcel
Type Const. Occupancy
West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
Main Floor I Upper Floors
Area of Decks
TYPE
7. OF
WORK
'NEW ❑ ALT. ❑ AD N. 0 RPL. ❑ MVE.
LwJ BLD. ❑ PLMB. (MECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths
Garage Area Storage
Finished Basement
Unfin. Basement
No. Stories No. Rooms No. of Dwellings
8.
DESCRIBE WORK
. •
VALUATION
9.
SOURCE
OF
UTILITIES
5ry
GAS
.1
y2
ELECTRIC
WATER
SEWER
CERTIFICATE
of EXEMPTION
Enum. Dist.
Req'd.
Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
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 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building i` off-'
Plumbing
Mech. 7` )
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $C C9C.
02*
*10.00
*1000 16
68.02
09-23-80
2 6.479,
04* *7,00
*7,00 5
6a12
09-23-80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Building echnician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
C9'-2P3'`'80 68.2z *'17,00a�
DATE ISSUED PERMIT NO. TOTAL