1983, 10-25 Permit: 83B-867 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
1. N- 12-;--(7--
LOT BLOCK
2.
SUBDIVISION
IPARCEL NO.
LEGAL DESCRIPTION:
Owl Q � I �y�
MAILING 3 ADDRESS
N • IZia
PHONE
PH NE
". 12a -
ZIP
ZIP
Actual Set Backs in Feet to:
North 'South I East I West
4.
cepyrizig-rrzy
M
LICENSE EXPIRES
ADDRESS
--2
ZIP
Size of Parcel
Zone Classification
Residential 0
Commercial 0
Type Const.
Occupancy
Sp 'nklered
Oyes DNo CReq'd.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
I
JI@f Jo. Dwellings Un(In.
Basement
Fin. Basement
TYPE .. NEW 0 ALT. ❑/AD'N. 0 RPL. 0 MVE.
7. OF 0 BLD. 0 PLMB. 4 MECH. ❑ M.H 0 POOL
WORK
0 OTHER
No. Baths
No Floors
No. Fin. Rooms
CertifI. of Exempt.
or Variance
Required YesO No0
Received VesO No❑
Number
DESCRIBE WORK
8. tisletA2 "re)\) .
Shorelines/Flood Haza d
Yes0 Not Apolic.❑
Plans Required 0
Received 0
VALUATION
9.
SOURCE GAS
OF
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 thls appl 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 FOR REQUIRED INSPECTIONS
1
a, G
SIGNATURE OF
OWNER OR AGENT
APPLICATION
DATE — 2 f — 8'3
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Flre
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
loZ
7
SPECIAL CONDI IONS: (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.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
20.
PERMIT NUMBER
04* *2000
*20.006
A *0.00 8
8662
10-25-83
6479.
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
4g:.i. C, i8,
DAT UE C" 3
–.
PERMIT NgI7 TOTAL
*
OlA ZQ01)OaI-