1983, 11-07 Permit: 83B-1374 Wood StovePLAN NUMBER
APPLICATIOIW/PERM,IT
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. 1: "Met LCsercramoo
PARCEL NO.
LOT
2.
BLOCK SUBDIVISION
OWNER
3. - C- L.a%t.)E.
PHONE
PHONE
CU -Co- 74tH
LEGAL DESCRIPTION:
MAILING ADDRESS
a✓. -1 tot �t ✓�l Lb
ZIP
QCLOIC4.
Actual Set Backs In Feet to:
North I South [East I West
4.
CONTRACTOR
S�r'vLd
LICENSE EXPIRES
PHONE
Size of Parcel 1 Zone Classification
Residential 0
Commercial 0
ADDRESS
GA rviE
ZIP
Type Const.
Omupancy
Spr nklered
[Wes ONo ❑Req'd.
5.
DESIGNER
PHONE
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unf in. Basement
TYPE LI NEW 0 ALT. ❑/D'N. 0 RPL. 0 MVE.
7. OF ❑ BLD. 0 PLMB.+O MECH. 0 M.H. 0 POOL
WORK
0 OTHER
No. Batts
No. Floors
No. Fin. Rooms
No. Dwellings
CertifI. of Exempt.
a Variance
Required Ves❑ - Non
Received Yes❑ No
Number
8.
9.
DESCRIBE WORK
VALUATION
Shorelines/Flood Hazard
Ves❑ Not Apollo. 0
Pare Req ired ❑
Received 0
SOURCE GAS
F
UTILITIES
ELECTRIC
WATER
PUBLIC 0
PRIVATE ❑
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 construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
OWNER OR AGEN
SIGNATURE OF APPLICA .��it G 3
DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Are
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
ar i
//7
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech. Z0.00
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ 7C' fhb
PERMIT NUMBER
a-13-rc4-
04* *2000
*20.006
A *000
13738
11-07-83
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
PERMITNfY. 7'"4'z' *2 OILO:. tAL