1983, 10-13 Permit: 83B-404 Wood StovePLAN NUMBER
(1
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
1. — 501
2.
oF-1J f' t
LOT BLOCK I SUBDIVISION
R
3 OI�E6z7lRclt. Wl
Nopz,FoRI
•7-
MAILING ADDRESS
ricla
' 6337
PHONE
co
sACAT_ F(,
4. ADDRESS
LICENSE EXPIRES
PHONE
JPARL
NO.
LEGAL DESCRIPTION:
Actual Set Backs In Feet to.
North !South tEast l West
Size of Parcel
Zone Classification
Residential 0
Commercial 0
ZIP
Type Const.
Occupancy
Spr nklered
Dyes ONo OReq'd.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE dEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
! OF 0 BLD. 0 PLMBECH. 0 M.H. 0 POOL
WORK
0 OTHER
No Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required YesD No0
Received Yes❑ NoD
Number
8DESCRIBE W090 266 /t
Shorelines/Flood Haza d
VesO Not Apollo. 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
I hereby certify that I have read and examined this appl cation 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 FO OUIRED INSPfxCjIONS
SIGNATURE OF
OWNER OR AGENT
APPLICATION /627/3
DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
0(13
I
SPECIAL CONDITIONS: (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.
Plan Check
SEPA
Modular/
MFG Home
Other (Specify)
TOTAL $ 20
PERMIT NUMBER
. 04* *2000
*20.00
A *000 8
4032
10-13-83
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
110 N131=84)3' 40,4'Z *2Q0.Oa 172
DATE ISSUED PERMIT NO. TOTAL