1981, 04-27 Permit M81A-3967 Wood StovePLAN NUMBER
PERMIT NUMBER
6
(V
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
S UIJUIVISION
ADp F, ty. M V . 0
CONTRACT
ADDRESS
DESIGNER
5' ADDRESS
6.
PHONE
,23`'X)I'7'
P
¢¢HONE
ZIP
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCE_ NUM3,:R/S
Actual Set Backs In Feet
North 'South East 'West
Size of Parcel Zone Classification
Type Const.
Occupancy Sprinklered
❑Yes DNo ❑ Req'd.
Valuation Building Area in Sq. Ft.
CHANGE OF USE FROM
TYPE
7. OF
WORK
ZIP
TO
CJ NEW ❑ ALT. 050 N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. CJ MECH. ❑ M.H. ❑ POOL
❑ OTHER
Main Floor Upper Floors I Garage Area Storage
8.
9.
DES RIBE WORK
I
4
VALUATION
ov 6
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Area of Decks I Finished Basement I Unfin. Basement
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private 0
No. Room
Req'd.
INo. of Dwellings
Rec'd.
Not Req'd.
Location (Area)
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 1` 0/ — YI SIGNATURE OF APPLICANT/A-071./.4L„,e,//� 9�/�5-i
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
FEES COLLECTED
Single $
Building
Plumbing
Mech. I 7
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
04*
*17.00
* 1 7,00
396.E o
04-27-8,1
6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
3196, 7 z * 1t' 7, 0.0 2•
;
PERMIT NO. TOTAL