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1983, 10-03 Permit: 83A-9842 WoodstoveVLAN ryUMOCM I HP'P'L-IVH 1 1VIN/ r-C.M /11 1 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. I:t- . 7 gj0 3 �ij � �N Received Yes❑ No❑ DESA IBE WORK 8• Shorelines/ Flood Hazard LOT LOCK SUBDIVISION LEGAL DESCRIPTION: Received ❑ 2. I SOOURCE 17B ELECTRIC WATPUBLIC ❑ SEPTISEWAGE Ownership FEES COLLECTED OWNE UTILITIES PHON r. PHONE SEWER ❑ Public ❑ Private ❑ 3. 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 � � . Building work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- MAI�LINGAQDRESS I I ZIP Actual Set Backs In eetto: SIGNATURE OF ��� APPLICATION �(� �j -70 ^ �cJ � � 7 , North South East West SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) CONTRACTQR FINAL LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential ❑ G�Commercial SEPA ❑ 4. Modular/ ADDRESS ZIP Type Const. Occupancy Sprinklered MFG. Home Fire Prevent. ❑Yes ❑No ❑Req'd. DESIGNER PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area 5. Other (Specify) Engineer Utilities ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse SEPA CHANGE OF USE FROM TO THIS SPACE, Cover Deck Uncv. Deck Fin. Basement Unfin. Basement 6. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building Tech. F J IN 180 DAYS _p 0 No. Baths No. Floors No. Fin. Rooms No. Dwellings TYPE^ ❑ALT. ❑�AD'N. Cl RPL. ❑ MVE. 7. OF --EW ❑OTHER WORK ❑ BLD. ❑ PLMB.71 MECH. ❑ M.H. ❑ POOL Certifi.ofExempt. Required Yes❑ No❑ Number YtHMII PUMUtH *2 U'O O*f-AL CL O U W J LL or Variance Received Yes❑ No❑ DESA IBE WORK 8• Shorelines/ Flood Hazard Plans Required ❑ Q� © Yes❑ Not Applic. ❑ Received ❑ VALUATION I SOOURCE GAS ELECTRIC WATPUBLIC ❑ SEPTISEWAGE 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 Building 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 Plumbing SIGNATURE OF ��� APPLICATION �(� �j -70 ^ OWNER OR AGENT tk.t.1,,Y)c�. DATE Mach. SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE Plan Check Env. Health SEPA Planning Modular/ MFG. Home Fire Prevent. Other (Specify) Engineer Utilities TOTAL $ SEPA PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS BECOMES A PERMIT. THIS SPACE, Plans Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building Tech. F J IN 180 DAYS _p 0 4. 2 UEDo PERMITO zDATE *2 U'O O*f-AL CL O U W J LL