1983, 06-14 Permit: 83A-5217 Wood StovePLAN NUMBER
i
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS N 1>RD TO MAKE 3 COPIES
PARCEL NO.
STREET
1.13 7 & -
ADDRESS
LOT
2.
BLOCK
SUBDIVISION
3. ° K L- I(MUIJ
MAILING ADDRESS
- 1360? NINKI
CONA�TOi�
4. ADDRESS
P�5..Ne, — 47z4PHONE
IPHONE
LICENSE EXPIRES
LEGAL DESCRIPTION:
Actual Set Backs In Feet to'
North (South East I West
Size of Parcel
Zone Classification
Residential 0
Commercial 0
ZIP
Type Const.
Occupancy
Spr nklered
OYes DNo OReg 'd.
5.
DESIGNER
PHONE
New Corot. 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
Unfin. Basement
TYPE NEW 0 ALT. 0 AD' N. 0 RPL.
7• OF
WORK 0 BLD. 0 PLMBAMECH. 0 M.H.
0 MVE.
0 POOL
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Cartifl. of Exempt.
cr Variance
Required Yes❑ No❑
Received Ves0 No0
Number
8.
DESC, f�WK S -OV
Shorelines/Flood Hazard
Yes Not Applic.0
Plans Requ red 0
Received 0
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
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
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 th9r state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE F r R REO • IRED INSPE 1 r NS .
SIGNATURE OF APPLICATION / �, _ � 6
OWNER OR AG .:, /� DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. ,FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
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)
Z0 -
TOTAL $
PERMIT NUMBER
04* *2000
*20006
A *0.00 S
521.62
06-14-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
016;--1.14=8'3 52171
DATE ISSUED ,+ PERMIT NO.
*20.00.a�
TOTAL