1983, 10-12 Permit: 83B-0340 Wood StoveAPPLICATION/PERMIT
�/ so SPOKANE COUNTY — DEP/$R{MIENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
PLAN NUMBER
STREET ADDRESS
1. k) 2.1 Lkc
PARCEL NO.
LOT
2.
BLOCK SUBDIVISION
3.
OWNER
(.4° 1L.LLtq,n. ec.,seT
MAILING ADDRESS
f`1. 4(0,-k
PHONE
PHONE
LEGAL DESCRIPTION:
i..L.LGLc�
ZIP
cjcu t (o
Actual Set Backs in Feet to.
North 1South I East I West
4.
CONTRACTOR
S la IVIG
ADDRESS
et47146
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential 0
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
TYPE 0 NEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
7. OF •
WORK 0 SLD. 0 PLMB.I2(MECH. 0 M.H.
❑ POOL 0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certlf1. of Exempt
or Variance
Required YesC No❑
Resolved YesD No0
Number
8.
9.
DESCRIBE WORK
LcZ.xx GTOU6
If
% -2> 1455r_ov.8c i
Shorelines/Flood Haze d
YesO Not Apollo. 0
Plans Requ'red 0
Resolved 0
VALUATION SOURCE
OF
UTILITIES
GAS
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 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
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 throvisions of any other state or local law regulating construction or the performance
of construction. SEE REV ' - - s E FOR REOUIRED k • NS
SIGNATURE OF �y
OWNER OR AGEN F^
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Pans
Exam.
Building
Tech.
APPLICATIO
DATE
SPECIAL ONDITIONS: (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. 2e) CO
Plan Check
SEPA
Modular/
MFG. Home
M1
Other (Specify)
TOTAL $ rat -g---)
PERMIT NUMBER
8s3 - c,40
04* *2000
33.9
10-12-83
2 6.479,
i-
0
CDV
W
-J
IJ -
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
^to
j j ' f, 1•
DATE1SLED`j12 ' � 3j Ni.PERMIT Y O z
*2 0.0 o TOTAL