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1983, 09-12 Permit: 83A-8960 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 STREET ADDRESS PARCEL NO. 1. )= _ 7 3oR 148x-ty LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: 2. OWNER PHONE PHONE 1_- "F_ 8-OAC14 crza-©zlz MAILING ADDRESS ZIP Actual Set Backs in Feet to: E__7301 'Liep- l Q Zl .3 North South East West CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification I Residential ❑ 4. SAME I Commercial ❑ ADDRESS ZIP Type Const. Occupancy Sprinkiered ❑Yes ONO ❑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 Unfin. Basement 6. TYPE 'NEW No. Baths No. Floors No. Fin. Rooms No. Dwellings E - El ALT. El AD' N. El RPL. 11 MVE. 7. El OTHER WORK 11BLD. ❑ PLMB. ®'MECH. ElM.H. C1POOL Cartifi.ofExempt. Required Yes❑ NOD Number or Variance Received Yes ❑ No ❑ DESCRIBE WORK 8. Shorelines/ Flood Hazard Plans Required ❑ wooD $'7'C YE tfYSruLf ri t: N Yes ❑ Not Applic. ❑ Received ❑ VALUATION 9• I SOOUFCE GAS ELECTRIC WTER PUBLIC ❑ 1 SEPT CG❑ Ownership FEES COLLECTED UTILITIES PRIVATE ❑ SEWER ❑ Public ❑ Private ❑ 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 other state or local law regulating construction or the performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing SIGNATURE OF APPLICATION cry OWNER OR AGENT DATE Mach. h Xig SPECIAL APPROVALS PRELIM. FINAL DATE Env. Health Planning Engineer Utilities SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) 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 ,no— Other Other (Specify) i2) TOTAL $ PERMIT NUMBER P63A– $ 9ro WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES AR PERMIT. Q a DATE'r55UED1 � - PERMIA9. 6 O z *20.00r°o' C CL C C: LL