1983, 10-11 Permit: 83B-309 WoodstovePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
IN NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 3 COPIES
STREETA DRESS . PARCEL NO.
2. LOT I BLOCK SUBDIVISION LEGAL DESCRIPTION:
OWNER PHONE .PHONE
3. 4 ('
s
MAIL& G AD�S`,
p
Actual Set Backs in Feet to:
1
North South East
I West
CONTRAQTORA
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
4.
ADDRESS
ZIP
Type Const. Occupancy
Sprinklered
❑Yes ❑No ❑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.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW C3 ALT. 11 RPL. F)MVE.
E'N.
% OF ❑OTHER
WORK El BLD. ElPLMB. MECH. 1:1M.H. El POOL
Certifi. of Exempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes El No❑
DESC
8•
IBEQR�K
Shorelines/ Flood Hazard
Plans Required ❑
�/�/ (j
Yes❑ Not Applic. ❑
Received ❑
VALUATION
I SOURCE
GAS
ELECTRIC
I pUBLIC WATER❑
SEPT CGE❑
Ownership
FEES COLLECTED
9•
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-
Building
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
0
OWNER OR AGENT
DATECATION
Mech.
SPECIAL APPROVALS SP IAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Utilities
Plans I I I I PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
i�
Tech.I K11 i
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
PERMIT NUMBER
TOTAL $ —= 1
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. �j
DATE7SS i1 1 — / PERMIT N6. O' 9 z
*20.00%SAL
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