1983, 09-29 Permit: 83A-9694 WoodstovePLAN NUMBER
APPLICATION /PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY b
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 3 COPIES
STREETADDRESS
PARCEL NO.
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
OWN R
ObE
PHONE
3.
MA G AP/DR--ESS
ZIP
Actual Set Backs in Feet to:
tl�J� I l.l�IfV922
North South East West
CONTFACT2P,
ENSE EXPIRES
FYHONE
Size of Parcel
Zone Classif ication
Residential
4
Commercial ❑
ADDRESS
ZIPType
Const.
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unf in. Basement
6.
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE PI NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF�,,v� ❑ OTHER
WORK ❑ BLD. ❑ PLMB. MECH. ,A�J"M.H. ❑ POOL Certifi.ofExempt. Required Yes❑ No❑ Number .
or Variance Received Yes❑ No❑
DESCStI� ORK �y Shorelines/ Flood Hazard Plans Required ❑
8• Zoo yes Not Applic. ❑ Received ❑
VALUATION I SOOURCE GAS ELECTRIC WATER
IC ❑ SEPT
WAC O Ownership FEES COLLECTED
9 UTILITIES PRIVATE ElSEWER 1:1 Public ❑ Private _T❑
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��� _ Q APPLICATION _
OWNER OR AGENT �"�'�/` DATE — Mech. 0,9�
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Engineer
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech.
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $ �J ' I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. ��}}
DATE 'IS ISSUED n _ ` ` PERMIT 'NO. 7 �i U %' AL
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