1983, 02-04 Permit: 83A-0829 WoodstovePLAN 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 PARCEL NO.
1. , _3i24)
2. LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
ONER
PHONE
PHONE
pl\i < -
3.
(qZ-A _'tcielc>
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
Zt1?_-, Ror7 6,c��
C(C(dA
North South East
West
CONTRACTOR
00
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
4.
ZIP
Type Const. Occupancy
Sprinklered
YYt£
I
I
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor UU=—kA
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Fin. Basement
Unfin. Basement
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW ❑ALT. ❑ AD' N. ❑RPL. ❑ MVE.
7. OF ❑OTHER
WORK ❑BLD. ❑ PLMB. W'MECH. ❑ M.H. ❑ POOL
Certifi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
D SCRIBE WORK
8
Shorelines/ Flood Hazard
Pians Required ❑
Vl:�OL�s,�t2t 3+r W f`�l 2� {� �c� 1J�
Yes❑ Not APPIic. ❑
Received ❑
VALUATION I
SOOUFCE
GAS
ELECTRIC
PUBLIWATC ❑
SEPT CG❑
1
Ownership
FEES COLLECTED
9.
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-
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 FO REOUIR INSPECTIONS
Plumbing
SIGNATURE OF ,` �}C,�J APPLICATION
OWNER OR AGEN Y _ DATE
Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Utilities
Plans i I I PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building 11 IN 180 DAYS
eild
Plan Check
SEPA
Modular/
MFG. Home
Other (Specity)
PERMIT NUMBER
6 - OE�izq
TOTAL $ = 1
WHEN MACHINE VALIDATED IN THIS
THIS BECOMES A PERMIT.
11T1Q Z,Ej 4- 8 PERMIT Nd. 2 9 Z * 5 O' 0 0 -*otnl
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