1982, 11-19 Permit: 82B-1210 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. a 50.5 1.10Lik
PARCEL NO.
LOT
2.
OWNER
3
BLOCK
SUBDIVISION
DIAt�h ' A AN!
PHONE
PHONE
r
LEGAL DESCRIPTION:
MAILING ADDRESS
CONTRACTOR
4.
ADDRESS
s- 1002- P1z->'
LICENSE EXPIRES
ZIP
PHONE
5�5 - 8741$
ZIP
Actual Set Backs in Feet to.
North 1South (East I West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Residential 0
Commercial 0
Spr nklered
DYes DNo DReq'd.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Man Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin Basement
UntIn. Basement
TYPE E NEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
7. OF 0 BLD. 0 PLMB. 2 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 NoD
Received YesO NoD
Number
DESCRI WORK
8. NEI✓!') c tr $ s -r
Shorelines/Flood Haze d
VesO Not Applic. 0
Plans Required 0
Received 0
VALUATION
9.
SOURCE GAS
F
UTILITIES
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 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 SIDE FOR REQUIRED INSPECTIONS
%' IG1'� in 7i
SIGNATURE OF APPLICATION 11 f j I �j
OWNER OR AGENT DATE
SPECIAL APPROVALS (IAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plana
Exam.
Building
Tech.
Y1/
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)
ZJ'
TOTAL $
PERMIT NUMBER
Se-&- 1z -Lo
04*
A
12092
11-19-82
2 6479,
*2000
*20.006
*Goo
0-
0-
-1 J
LL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEf$tEDi 9 -B 2
PERMIT/4c? 1 0 *2 Q 0 0
O F�F
fl7TAL