1983, 09-12 Permit: 83A-8916 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
E . Yl G t 5 W1;axwetc.
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
OWNER
3. U'avr.1E tcc,tcty
MAILING ADDRESS
E. i V R i s Ark Lusc.f_.
PHONE
PHONE
AU1- 4831
LEGAL DESCRIPTION:
ZIP
Ctetot
Actual Set Backs In Feet to.
North . ._- _ISouth_ _ ___ (East_ .
4.
CONTRACTOR
earvito
ADDRESS
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential 0
Commercial ❑
ZIP
Type Const.
Occupancy
Spr nkiered
:Wes ❑No DAN 'd.
5.
DESIGNER
PHONE
New Const. Valuation
Remodeled 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. ❑,AD'N. 0 RPL. ❑ MVE.
7. OF BLD. ❑ PLMB. ®MECH. 0 M.H. 0 POOL
WORK
0 OTHER
No. Baths
No Floors
No. Fin. Rooms
No. Dwellings
Gerbil. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes❑ Neu
Number
DESCRIBE WORK
8. 014S0N2S4 all t IVE-j to/ 1,i:9DSrouS
WATER
PUBLIC 0
PRIVATE 0
VALUATION
9.
SOURCE int
OF
UTILITIES
GAS
ELECTRIC
Shorelines/Flood Haza d
Yes❑ Not Apollc.❑
Pans Requ red ❑
Received ❑
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 compiled 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 EOUIRED INSPECTIONS
SIGNATURE OF APPLICATION6`
OWNER OR AGENT DATE—� —v
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plana
Exam.
Building
Teen.
PERMIT IS NONTRANSFERABLE r/
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)
3es ..SO
TOTAL $ 330
PERMIT NUMBER
`SA —eR b
04* *30.00
*30.006
A *0.00- o
891,5
09-12-83
B 6479.
of
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
iJ
09 71,2=8.3 89L6i� *3QOOa�
DATE ISSUED PERMIT NO. TOTAL