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1983, 09-23 Permit: 83A-9446 Wood StovePLAN NUMBER r 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 1. STREET ADDRESS . Izzo ee'NE. PARCEL NO. LOT BLOCK SUBDIVISION 2. OWNER 3' -i -0/3E42 ---i• VAN DoREN PHONE q2-,-©5zo PHONE MAILING ADDRESS ZIP E _ 1 2:7,,o 2 cN- c/cizo4. PHONE CONTRACTOR 4. 5# ii ADDRESS LICENSE EXPIRES DESIGNER 5. ADDRESS CHANGE OF USE FROM 6. LEGAL DESCRIPTION: Actual Set Backs in Feet to: North I South I East I West ZIP PHONE ZIP TO TYPE ❑ NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE. 7. OF WORK ❑ BLD. ❑ PLMB. 171MECH. ❑ M.H. ❑ POOL ❑ OTHER DESCRIBE WORK 8. W001) STOVE, ^ c:14(f1”,4 y f AK; NR VALUATION SOURCE GA ELECTRIC UTILITIES 9. WATER PUBLIC ❑ PRIVATE ❑ SEWAGE SEPTIC 0 SEWER 0 Size of Parcel Type Const. Zone Classification Occupancy Residential ❑ Commercial ❑ Sprinklered ❑Yes ❑No Req 'd. New Const. Valuation Main Floor Cover Deck No. Baths Certifi. of Exempt. or Variance Remodeled Valuation Total Bldg. Floor Area Upper Floors Garage/Storage Greenhouse Uncv. Deck Fin. Basement Untin. Basement No. Floors No. Fin. Rooms No. Dwellings Required Yes No❑ Received YesE No❑ Shorelines/ Flood Hazard Yes ❑ NotApplic. ❑ Ownership Public 0 Private 0 1 hereby certify that 1 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' APPLICATION c„)..._ OWNER OR AGENT/It i hl sALZnJ :fit--.-. / DATE 02 3 SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE Env. Health Planning Fire Prevent. Engineer Utilities SEPA Plans Exam. Building Tech. Number PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS Plans Required E Received ❑ FEES COLLECTED Building Plumbing Mech. Plan Check SEPA Modular/ MFG. Home Other (Specify) II; .XX OC TOTAL $ 30 PERMIT NUMBER e31-1440 04* *30.00 *30,00 ;44, 52 09-23-83 6479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATE4S9UE2 3 -8 3 PERMITS 4. 4 6 0 *3 O. 0 Q IOTAL