1983, 10-26 Permit: 83B-913 Wood StovePLAN NUMBER
APPLICAT4I0i/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
1.
PARCEL NO.
North 216 Blake
LOT
2.
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
3
4.
OWNER
Jack Hamlin
MAILING ADDRESS
East 13607 Main
CONTRACTOR
Same
ADDRESS
PHONE PHONE
928-4540
ZIP
99216
LICENSE EXPIRES PHONE
ZIP
DESIGNER PHONE
5.
ADDRESS
CHANGE OF USE FROM
6.
ZIP
TO
TYPE It NEW ❑ ALT. ❑I AD' N. ❑ RPL. Cl MVE.
7. OF WORK ❑ BLD. ❑ PLMB. tl MECH. CI M.H. ❑ POOL ❑ OTHER
Actual Set Backs in Feet to:
North 'South {East I West
Size of Parcel I Zone Classification
Type Const.
Occupancy
Residential
Commercial I
Sprinklered
[Wes ❑No CIReq'd.
New Const. Valuation
Remode ed Valuation
Total Bldg, Floor Area
Main Floor
Upper Floors
Garage/Storage
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Cerfifi. of Exempt.
or Variance
IRequired Yes❑ No❑
Received Yes❑ No❑
Number
DESCRIBE WORK
8 Installation of woodstove
VALUATION
9.
SOURCE
F
UTILLIITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
Shorelines/Flood Hazard Plans Required L.
YesE Not Applic. -: Received ❑
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 - sions of an otr :r state or local law regulating construction or the performance
of construction. SEE REV SE SID FOR R 0U ED INS ACTIONS
SIGNATURE OF '% APPLICATION
OWNER OR AGENT I % // I DATE /O
SPEC4AL APPROVAL
PRELIM. FIN DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
r3/
g,
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
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. Horne
Other (Specify)
20.00
TOTAL $ 20 . 00
PERMIT NUMBER
04* *2Q00
*2Q00'6
A *0.00 n
91.28
10-26-83
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-▪ 26• -33
DATE ISSUED
PERMIT NO. / Z * 2 O. O O &AL