HomeMy WebLinkAbout1984, 01-16 Permit: 84A-462 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
kij n1 ANI W
PARCEL NO.
LOT
2.
LOCK
UBDIVISION'
OWNE
3. P 5c1 -k3 ETICPEL-Z
MAILING ADDgESS
- g -
PHONE
�2 -977O
LEGAL DESCRIPTION:
ZIP
CPl2p(a
Actual Set Backs in Feet to:
North ISouth [East I West
4.
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel 1 Zone Classification
Residential D
Commercial 0
ADDRESS
ZIP
Type Const.
Occupancy
Sp nklered
OVes CNo DReq'd.
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
Fln. Basement
Untin. Basement
7.
TYPE /NEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
OF ❑ BLD. 0 PLMB/ MECH. 0 M.H. 0 POOL
WORK'
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required YesD No❑
Received Ves° No0
Number
8.
DESCRIBE WORK
WW2 StOVt
Shorelines/Flood Hazard
Yes° Not Apolic.0
Plans Req Ired 0
Received 0
VALUATION
9.
SOURCE
F
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 app['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 the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE Fsj REOUIREDJNSPEC IONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
,Env. Health
Planning
FIre
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
0 ea
APPLICATION /4 -t--
DATE
SPECIAL CONDITIONSY(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. 7.0I°0•�
Plan Check
SEPA
Modular/
MFG. Home
Other (Spicily)
OQ
TOTAL S 2e2t f
PERMIT NUMBER
PIA - -491
04* *2000
*20.006
A *000
4612
01-16-84
2 6479.
0
0
Ci
W
J
LL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
� jj ,Vr4. Z '
DATEY5SUED1 6 - 8'4
PERMIT NsrI: 6 2 z *2 O. 0 0 t AL