1983, 12-19 Permit: 83B-2662 WoodstovePLAN NUMBER APPL ICAT ION /PERMIT PERMIT NUMBER
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 DDRESS PARCEL NO.
1. - +7, L I LiL lNQ
2. LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
OWNER ONE PHONE
3.
_ 7
North South East West
CONTRA TO
7. ❑OTHER
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential 11J
Required Yes❑ No❑
Number
WORK El BLD. ElPLMB.,Z! MECH. F-1 M.H. ❑ POOL
or Variance
Received Yes❑ No❑
Commercial ❑
DESCRIBE
8�
4.
Shorelines/ Flood Hazard
Plans Required ❑
Yes El Not Applic. ❑
Received ❑
VALUATION
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Ownership
FEES COLLECTED
9•
I
❑Yes El No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
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 whethK specified herein or not. The granting of a permit does not presume to give au-
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
Plan Check
6.
-
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE XNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. ❑OTHER
Certifi.ofExempt.
Required Yes❑ No❑
Number
WORK El BLD. ElPLMB.,Z! MECH. F-1 M.H. ❑ POOL
or Variance
Received Yes❑ No❑
DESCRIBE
8�
ORK
Shorelines/ Flood Hazard
Plans Required ❑
Yes El Not Applic. ❑
Received ❑
VALUATION
SOOUFCE
GAS
ELECTRIC
WATPUB LC
SEPTIC El
Ownership
FEES COLLECTED
9•
I
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
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
Building
work will be complied with whethK specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel t rgGisions of any other state or local law regulating construction or the performance
of construction. SEE REVS Sl� IDE F EQUIRED INSPECTIONS
Plumbing
SIGNATURE OF /J , APPLICATION
G
OWNER OR AGENT DATE
Mech.
SPECIAL APPROVALS USPECIAL
CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DAT
Plan Check
Env. Health
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Other (Specify)
Engineer
Utilities.
'TOTAL $
SEPA
HEN MACHINE
Plans PERMIT IS NONTRANSFERABLE TrHIS B COMES A PERM TTED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Tech.Buil ing z� IN 180 DAYS ryLZ L n
.b�..TFWFn+ 11
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LL