1984, 01-20 Permit: 84A-602 WoodstovePLAN NUMBER IAPPLICATION /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
STREETADDRESS PARCEL NO.
I:Zc? PkAp
Lor w BLOCK I SUBDIVISION LEGAL DESCRIPTION:
2.
OWN R PHONE PHONE
7 -1
K , lz"'24- F7-<,-fv, L,'
CONTRACTOR LICENSE EXPIRES PHONE
4. ADDRESS ZIP
DESIGNER PHONE
5.
ADDRESS zip
CHANGE OF USE FROM TO
6.
North South East I West
Size of Parcel Zone Classification Residential ❑
Commercial ❑
Type Const. Occupancy Sprinklered
❑Yes ❑No ❑Req'd.
New Const. Valuation Remodeled Valuation Total Bldg. Floor Area
Main Floor per Floors Garage/Storage Greenhouse
Cover Deck Uncv. Deck Fin. Basement Unfin. Basement
PERMIT NUMBER
A — ®G--
TYPE �/
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
EW ❑ALT. O AD'N. ❑RPL. El MVE.
7. OF ,I�f N❑OTHER
WORK ❑ BLD. ❑ PLMB.JMECH. ❑ M.H. ❑ POOL
Certifi. of Exempt.
Required Yes❑ No❑
Number
or Variance
Received Yes No❑
DESCRIBE WORK
8•
Shorelines/ Flood Hazard
Plans Required ❑
N000 '5 fo ytzl
Yes Not Applic. ❑
Received ❑
VALUATION
9•
SOOUFCE
GAS
ELECTRIC
PUBLICWATEO
SEPT C 11 I SEWAGE
Ownership
FEES COLLECTED
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 €
/ %�, "i�—� " q�!J
OWNER OR AGENT -��—�% = - DATE
Mech. 4-
SPECIAL
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)
G�
Engineer
Utilities
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE
MACHINE
HEIS BECOMES A PERM TTED IN THIS SPACE,
Plans
Exam.j
J1
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
IN 180 DAYS
Tech.%f r' }
�tl DAT�SSUED2 0— 8 4 PERMITNyD.ilLL r
'� , 2 55 * 2 0, 0 0 �QTAL
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