1983, 11-14 Permit: 83B-1600 Wood StovePLAN NUMBER
APPLICATI PERMIT
SPOKANE COUNTY — DEPAR' f 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. 2103
to cus-r
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
OWNER
3. E,J- aVA-MS
MAILING ADDRESS
N• 2/03 Z_oct./st
PHONE
c126— O I z7
PHONE
LEGAL DESCRIPTION:
ZIP
92.D6
Actual Set Backs in Feet tot
North 'South
CONTRACTOR
4. SII111E
ADDRESS
LICENSE EXPIRES
PHONE
Size of Parcel
11 Zone Classification
East
West
Residential ❑
Commercial 0
ZIP
Type Const.
Occupancy
Spr nklered
❑Yes ONo ❑Req'd.
5.
DESIGNER
PHONE
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
7.OF
TYPE( LA'fJEW
WORK 0 BLD.
❑ ALT. 0 AD' N. 0 RPL. ❑ MVE.
❑ PLMB. f3-MECH. 0 M.H. ❑ POOL
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certif1. of Exempt.
or Variance
Required Yes❑ No❑
Received YesO No❑
Number
DESC1.xI BE WORK
8. woos s-roVE. /K5?hLLA'T7DMr6M2A4E.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
Shorelines/Flood Hazard
Yes❑ Not Applic.❑
Plans Requ red ❑
Received 0
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC ❑
SEWER 0
Ownership
Public 0 Private 0
I hereby certify that 1 have read and examined this 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 REVERS DE FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION
7/72.4..�r DATE
CIAL CONDITIONS: (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)
,2p
D>�
TOTAL $ adrY
PERMIT NUMBER
838- 1600
04* *2000
*20.00
*20006 _
A *000 s
159:9g
11-14-83
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. _
• ''II j hie -4:v. ti ;
DATEISSUEDI 4 - 8 3
PERMITY76' Q O 5 * 2:0. O O *OTAL