1983, 08-30 Permit: 83A-8396 Wood StovePLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS I ALCILJ 9-1A
1.
LOT
2.
BLOCK
SUBDIVISION
PARCEL NO.
LEGAL DESCRIPTION:
3.
4.
OWN�r�
MAILING ADDRESS
CONTRACTOR
`
ADDRESS
V9#
P-rs-14--
PHONE
LICENSE EXPIRES
HONE
Actual Set Backs in Feet to:
North ISouth East West
Size of Parcel
LIZone Classification
Residential ❑
Commercial ❑
ZIP
Type Const.
Occupancy
Sprnklered
❑Yes El No ❑Req'd.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage /Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF
WORK ❑ BLD. ❑ PLMB. ECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certif1. of Exempt.
or Variance
Required Yes❑ Non
Received Yes ❑ No 7,
DESCRIBE e WORK
8.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
Shorelines/ Flood Hazard
Yes Not Applic. ❑
Number
Plans Required ❑
Received ❑
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
Ownership
Public ❑ Private ❑
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 au-
thority 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
SIGNATURE OF APPLICATION
OWNER OR AGENT iii _ ,.`� DATE
SPECIAL APPRO LS SPECIAL CO IONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. Fl AL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUM ER7e
04* *2000
839.52
08 -30 -83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
O8` -30 -83
DATE ISSUED
PERMIT N30.9. 6 z * 2 0. 0 0 F&TAL