1983, 12-30 Permit: 83B-2889 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3875
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
OWNE��J N] -c,11 -L. f I. ! t1I IPIicINE
liL'C/�V' V +'f/i� �i N
LEGAL DESCRIPTION:
MAILING ADID7r 1 _ �J c
4.
ADDRESS
CONTRA QPo 6
LICENSE EXPIRES
5.
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
ZI
PHONE
ZIP
PHONE
ZIP
TO
TYPE NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF
WORK ❑ BLD. D PLMB.-EIVMECH. D M.H. ❑ POOL
❑ OTHER
8 DESCRIBE OjIC 4-7--(0\/
'/
VALUATION
9.
SOURCE
F
UTILLIITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC
SEWER ❑
Actual Set Backs in Feet to:
North (South
[East
Size of Parcel
Type Const. Occupancy
New Const. Valuation
WPM
Zone Classification
Residential 0
Commercial 0
Sprinklered
❑Yes ❑No ❑ Req 'd.
Remode ed Valuation
Main Floor Upper Floors GaragelStorage
Cover Deck
No. Baths
Total Bldg. Floor Area
Uncv. Deck
No. Floors
Certlfl. of Exempt.
or Variance
Fin. Basement
Greenhouse
No. Fin. Rooms
Untin. Basement
No. Dwellings
Required Yes LI No ] Number
Received Yes,- Non
Shorelines/Flood Hazard
Yee❑ Not Applic. ❑
Ownership
Public O Private 0
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
SIGNATUREOF\11 APPLICATION
OWNER OR AGE - i /\ • 7� 0.�.�- . DATE / 2 30 ` 3
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required fi
Received E
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
,gyp) z
04* *2000
28888
12-30-83
g 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE IESUII O 8 3
PERMITNO.8 9
*2 O.O O 4irAL