1982, 11-19 Permit: 82B-1233 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
N 4701+
LOT
2.
BuMN 5 ROAD
PARCEL NO.
BLOCK
SUBDIVISION
OWNER
3 J I✓RR`j K O IA LI E -BER_
MAILING ADDRESS
N BuR•nis ROAD
CONTRACTOR
4. sA'M r%
ADDRESS
PHONE
`I:14-3/ 72
PHONE
LEGAL DESCRIPTION:
ZIP
8921h
LICENSE EXPIRES
PHONE
Actual Set Backs in Feet to:
North 'South East I West
Size of Parcel Zone Classification
Residential ❑
Commercial ❑
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No Req 'd.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remode ed 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 [91QEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF WORK ❑ BLD. ❑ PLMB. 21-MECH. ❑ M.H. 10POOL ❑OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes No❑
Number
8.
9.
DESCRIBE WORK
kloop 5-To\J
VALUATION
1 N s TAL L_A-rl-oN
Shorelines/Flood Hazard
Yes ❑ Not Applic. ❑
Plans Required ❑
Received El
SOURCE
F
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC 0
SEWER ❑
Ownership
Public ❑ 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
SIGNATURE OF -.
OWNER OR AGENT
1
APPLICATION
DATE 1 1-
j _1 _ (6 9\
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
PERMIT IS NONTRANSFERAAi E
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
DO
Mech.
Plan Check
SEPA
Modular/
MFG. Home
issue 00
Other (Specify) /0
op
TOTAL $ zv.
PERMIT NUMBER
fig- Li33
(_ v
11--i''
ti LI72
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEfSSF/ED1 9 - 8 2
PERMIT) 3 3 2