1983, 09-19 Permit: 83A-9214 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
1.
STREET ADDRESS
6.. \1St\ YYtfitt )
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
OWNER
MAQc_ 14,10- CO•4
MAILING ADDRESS
E . 11511 Milo Pa
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
egazoc
CONTRACTOR
4. C
ADDRESS
LICENSE EXPIRES
PHONE
Actual Set Backs In Feet to.
North I South `East l West
Zone Class!' 'cation
Size of Parcel
Residential 0
Commercial 0
ZIP
Type Const.
Occupancy
Spr nklered
OYes ONo ❑Req'd.
5.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unf in. Basement
TYPE 17 NEW 0 ALT. ❑9D'N. 0 RPL. ❑ MVE.
WORK ❑ BLD. 0 PLMB. MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi of Exempt.
or Variance
Required Yes❑ No❑
Received Yes No❑
Number
8.
DESCRIBE WORK
WOO 0S—Co0le
Shorelines/Flood Hazard
Yes❑ Not AspIIc. 0
Plans Required 0
Received 0
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private ❑
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 the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REOUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT -31
SPECIAL APPROVALS
APPLICATION
DATE x.9-/9-93
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL
DITIOMS: (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. Z...6 :CO
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ 7.0 oi
PERMIT NUMBER
83�-a�14
04* *20.00
*2Q006
A *0.00 8
921.32
09-19-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
(�
j t,
DATEQSSQQ UED .9 - 8�.3;
NPERMIT g. L'Y Z * L u O O TOTAL