1983, 06-29 Permit: 83A-5953 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
STREET ADDRESS
1.
LOT
2.
PARCEL NO.
East 1312 Heroy
BLOCK
SUBDIVISION
OWNER
3 Dan Burns
MAILING ADDRESS
East 13125 Heroy
PHONE
922-624?
PHONE
LEGAL DESCRIPTION:
ZIP
99216
CONTRACTOR
4 Same
ADDRESS
LICENSE EXPIRES
PHONE
Actual Set Backs in Feet to:
North ISouth [East I West
Size of Parcel
Zone Classification
Residential 0
Commercial 0
ZIP
Type Const.
Occupancy
Spr nklered
❑Yes CNo CReq'd.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE 0 NEW 0 ALT. 0 AD' N. 0 RPL. D MVE.
7• OF 0 SLD. 0 PLM B.IX MECH. 0 M.H. 0 POOL
WORK
0 OTHER
NO Batns
No. Floors
No Fin Rooms
No. Dwellings
Cerlif1. of Exempt.
or Variance
Required VesO No0
Received VesO No0
Number
8.
DESCRIBE WORK
Installation of wood stove
Shorelines/Flood Hazard
YesO Not Apolic.0
Plans Required 0
Received 0
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
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 : provisions of any other state or local law regulating construction or the performance
of construction. SEE REV A• E SIDE FAR REUIRED INSPECTIONS
6
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
APPLICATION (D / ,
_ / G ?
DATE d J
Env. Heath
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT 15 NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Nodular/
MFG. Horne
Other (Specify)
20.00
TOTAL $ 20.00
PERMIT NUMBER
05A-5953
,c
04* *20.00
*20.008
A *000 0
5952
06-29-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
06-29-830,, *20.000-1-
DATE ISSUED PERMIT NO. TOaAL