1983, 10-13 Permit: 83B-411 WoodstovePLAN NUMBER ArrLIL;A 1 IUN/1' ILKIVII I
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 PARCEL NO.
2. LOT BLOCK I SUBDIVISION LEGAL DESCRIPTION:
OW ER� /. l In,
^l PHONE
3.
MLING ADDRESS
Actual Set Backs in Feet to:
North South East
West
CON TO
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential El4.
Commercial ❑
ADDRESS
ZIP
Type Const. Occupancy
Spri nklered
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. 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.
�W
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
El ALT. 11A�/D' N.
❑RPL. 1-1MVE.
� OFPE
❑OTHER
WORK ❑ BLD. ElPLMB. 1;i ECH.
❑ M. H. ❑ POOL
Certifi. of Exempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
DESCRI E WORKv, f,A
8• �� (5
Shorelines/Flood Hazard
Plans Required ❑
�J
Yes❑ Not Applic. ❑
Received ❑
VALUATION
9•
SOOUFCE
GAS
ELECTRIC
WATER
PUBLIC ❑
SEWAGE
SEPTIC El
FEES 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 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 0bZ*O6JLEQUIRED
INSPECTIONS
Plumbing
SIGNATURE OF
ov APPLICATION
OWNER OR AGENT
DATE --vjL�
Mech.� .
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
BuiTech. g s IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
PERMIT NUMBER.
baa -4il
Other (Specify)
2,61
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10=13-8 3 41,1 z
DATE ISSUED PERMIT NO.
*20.00°'
TOTAL
CL
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C.3
W
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