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1980, 10-24 Permit M80B-2623 Wood StovePLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT PERMIT NUMBER NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HAR" TO MAKE 3 COPIES JOB ADDRESS L, LO BLOCK SUB IVISION O NER t,/- - ,y� i ll.r t .L�it-1�UjyiL XX . ADDRESS CONTRACTOR` „6-ad 4./L�' ADDRESS _4 A' DESIGNER ADDRESS CHANGE OF USE FROM 6. TYPE 7. OF WORK O NEW ❑ BLD. ❑ ALT. ❑ PLMB. PHONE 9dwL-/7 ZIP %9.za6 PHONE ZIP PHONE ZIP TO ❑ AD N. R. MECH. ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL 0 OTHER LEGA-L. DE, CRIPTION — SEE ATTACHED PARCEL NUMBER/S Actual Set Backs in Fee North South Size of Parcel Type Const. Occupancy East Valuation Main Floor Upper Floors Area of Decks No. Baths West Zone Classification Sprinklered ❑Yes DNo ❑ Req'd. Building Area in Sq. Ft. Garage Area Finished Basement No, Stories CERTIFICATE of EXEMPTION Storage Unfin_ Basement No. Rooms Req'd. ESCRIBE W• RK i VALUATION 9. SOURCE GAS OF UTILITIES ELECTRIC WATER SEWER Enum. Dist. I Location (Area) Ownership Public D 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 INSPECTIO DATE OF APPLICATION �G>' �2 rC�) SIGNATURE OF APPLICA 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 7 Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL de 04* *700 *7.00 17) 26222 10-24-80 2 6479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. Buildin Te hnici & PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE 1)-24-8a DATE ISSUED 2�62.35 *7,002 PERMIT NO. TOTAL