1983, 08-08 Permit: 83A-7472 Wood StovePLAN NUMBER
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.
2.
STREET ADDRESS
tc, .t -c3 sc Cr.
PARCEL NO.
LOT
BLOCK
SUBDIVISION
OWNER
3. -S041N Alvso v
MAILING ADDRESS
S.. -34-L Co poet CT. •
CONTRACTOR
4. .SAME
ADDRESS
PHONE
PHONE
42zr °Cite
LEGAL DESCRIPTION:
ZIP
LICENSE EXPIRES
PHONE
Actual Set Backs in Feet to:
North I South `Fast I West
Zone Classification
Size of Parcel
Residential 0
Commercial 0
ZIP
Type Const.
Occupancy
Sp nklered
OVes ONo ❑Raga.
5.
DESIGNER
PHONE
New Const. Valuation
Remodeled 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
Unfin. Basement
TYPE I NEW ❑ ALT. ❑AD. N. ❑ RPL.
7. OF 0 BLD. 0 PLMB. IS/MECH. 0 M.H.
WORK
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Fin Rooms
No Dwellings
Certif1. of Exempt.
a Variance
Required YesO No❑
Received Yes❑ No❑
Number
8.
9.
DESCRIBE WORK
CICCCit >YZiV C hl
VALUATION
SOURCE
F
UTILITIES
S -t -c3 LDC.
Shorelines/Flood Hazard
Vesl Not Apollo. 0
Plans Req 'red 0
Received 0
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER D
Ownership
Public D Private 0
I 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-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE DEFOR REQUIRED INSPECTIONS
OWNER OR AGE�I'P� Al/l -V -'LL "/td#r1 DATE
CAT• q_g-e3
SIGNATUREOF
SPECIAL APPVALS
PRELIM. FINAL DATE
Env. Health
SWILL`''
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
Com"?
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
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
B Ft- 7412-
00r *20.00
*2Q006
A *0.00 .8
747.12
0808-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSOEDO Ot • PERMIT NO. •7.2 Z k uo OTOTAL