1983, 09-20 Permit: 83A-9295 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT -OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
L/ APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
STREETpDDRZ-1 �� Pak
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
3. OwNibs] ea....71/41/2:5
4.
MAIrJ• LNG ADD ESS
z z ?.
=gel
ADDRESS
PHONEPHONE
720 -e6-56.-
z-fZ
LICENSE EXPIRES
PHONE
LEGAL DESCRIPTION:
Actual Set Backs in Feet for
North 'South
[East
west
Slee of Parcel
Zone Classification
Residential 0
Commercial 0
ZIP
Type Const.
Occupancy
Spr nklered
DYes DNo DReq'd.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deaf
Uncv. Deck
Fin. Basement
UnfIn Basement
7.
TYPE
OF 0 BLD.
WORK
YINEW
DESC I f) @EyJORK
8.
VALUATION
9.
0 ALT.
0 PLMB.
❑,9D'N. 0 RPL. 0 MVE.
MECH. 0 M.H. 0 POOL
0 OTHER
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC D
SEWER 0
No Baths
No. Floors
No. Fin Rooms
No Dwellings
CertlfI. of Exempt.
or Variance
Shorelines/Flood Hazard
YesO Not Apolic.0
Ownership
Public 0 Private 0
Required YesD No0
Received YesO No0
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
SIGNATURE OF
OWNER OR AGENT C.GT�'•L
APPLICATION ! 0/E3
/C ��z //
DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech
kJ'
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Number
Plans Requ red 0
Received 0
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
- o -
TOTAL $
PERMIT NUMZER
04* •3Q00
92942
09-20-83
2 6479.
>-
C-1 V
W
—J
U -
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMESA PERMIT.
09-20-8'3 929.55
DATE ISSUED PERMIT NO.
*3O.00a�
TOTAL