1983, 09-02 Permit: 83A-8544 Wood StovePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTh4tNT bF BUILDING & SAFETY
NORTH 811 JEFFERSON /.SPOKANE, WASHINGTON 99260 / (509) 456-3675
`--� APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
srR ET ADDRESS PARCEL NO.
1. 2:1G
2. LOT BLOCK I SUBDIVISION LEGAL DESCRIPTION:
0m-�'-+ '^
N� -03
0 6 `O
PHONE
3.
M LING ADDRESS
Actual Set Backs in Feet to:
9
!/ T�
North South East
West
CONTRgCT
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
4 L,�%f
Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Oonst. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW 0 ALT. 0 AD'N. 0 RPL. El MVE.No.
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB.,2-0ECH. ❑ M.H. ❑ POOL
Certifi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
DESC BE WOFiI( I ' )�
8• C-��
Shorelines/Flood Hazard
Plans Required ❑
O J v
Yes❑ Not Applic. ❑
Received ❑
VALUATION
SOOFCE
GAS
ELECTRIC
PUBLIWATC ❑
1
SEPTIC ❑
Ownership
FEES COLLECTED
9
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
1 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-
Building
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
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT
/ DATE
%ZZ 02
Mach. Zo'
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Utilities
SEPA
Plans
Exam.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify) 11
,W
TOTAL $
PERMIT NUMBER
04* *20,00
*20001
A *0,00 00
854.39
09-02-83
9 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0' 9DATE (ISSUED 8 PERMA7 . 4.4:23- *21000'
O
C.)
W
J_
U.