1983, 03-09 Permit: 83A-1654 Wood StovePLAN N
UMBER 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 AQDRESS
-•'z-rd02 c.4,6464-100
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
OWNER
3. Jo Mtf 14O
MA IN ADDRESS ✓
v'. I2Q02- OrP..k70
PHOS-gsrPHONE
U/�/lC�J .E
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 'South [East 1 West
4.
CON
LICENSE EXPIRES
PHONE
Size of Parcel 1 Zone Classification
Residential 0
Commercial 0
ADDRESS
ZIP
Type Const.
Occupancy
Sp nklered
0Ves ONo OReq'd.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE NEW 0 ALT. 0�� /AD'N. 0 RPL. 0 MVE.
7 o OTHER
WORK 0 BLD. 0 PLMB. LXMECH. 0 M.H. 0 POOL
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certif1. of Exempt.
or Variance
Required Ves0 No0
Received Yes❑ NO0
Number
DESCRIBE WORK
Shorelines/Flood Hazard
Ves0 Not ApplIc. 0
Plans Required 0
Received 0
VALUATION
9.
SOURCE
F
UTILLIITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
I hereby certify, that I have read and examined this appl cation 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 constructlon.SEE REVERSE SIDE FOR REQUIED INSPECTIONSTI
SIGNATURE OF M v� _ / APPLICATION q 73.
OWNER OR AGENT ( DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
37
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 NUMBER
&A- V954—.
*2000
*20.00
A *0.00 8
165.32
03-09-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE
LSLCI '9 :8'31
16'542 *21f002.PI
PERMIT NO. TOTAL