1984, 02-28 Permit: 84A-1670 WoodstovePLAN NUM131--H I AFVL IcrA i 1U W / PERMIT
LPERMIT NUMBER
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
STREETADDRESS PARCEL NO.
LOT BLOCK I SUBDIVISION LEGAL DESCRIPTION:
2.
OWNERP ONE PHONE
rn i Ci a 7 "7
3. `` '
SPECIAL APPROVALS
PRELIM. FINAL D,
Env. Health
Planning
Prevent
Utilities
SEPA
Plans
Exam.
Building
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)
00
TOTAL $
WHEN MACHINE VALIDATED IN THIS
THIS BECOMES A PERMIT.
wi
E,
DATE` _ilE ` PERMITN6. % 0 z 2 0, O 0 $OPAL
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MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
North South East
West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
4'
Commercial ❑
ADDRESS
ZIP
Type Const. Occupancy
Sprinklered
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
�J.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
TYPE .NEW 13 ALT. 1:1AD'N. El RPL.
ElMVE.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
7.
OF WORK E3 BLD. 13PLMB.AMECH. ElM.H.
El POOL ❑OTHER
Certifi. of Exempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No r-1
8
DESCRIBEWORK , `��.�� C �� r
�J�c/ �' moi'
Shorelines/ Flood Hazard
Plans Required ❑
Yes Not Applic. ❑
Received ❑
9•
VALUATION
I SOOUFCE
GAS
ELECTRIC
PUBLIC WATER
SEPTIC O
°i""h'p
FEES COLLECTED
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
p p
not. The granting of a permit does not resume to
g g p p 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
p eI
OWNER OR AGENT
DATE
Mech. L�
SPECIAL APPROVALS
PRELIM. FINAL D,
Env. Health
Planning
Prevent
Utilities
SEPA
Plans
Exam.
Building
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)
00
TOTAL $
WHEN MACHINE VALIDATED IN THIS
THIS BECOMES A PERMIT.
wi
E,
DATE` _ilE ` PERMITN6. % 0 z 2 0, O 0 $OPAL
CL
O
V
W
J_
LL