1983, 12-08 Permit: 83B-2389 WoodstovePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
or Variance Received Yes❑ No❑
8 DESCRIBE WORK Shorelines/ Flood Hazard Plans Required ❑
Uj 001�.� lG� V � Yes❑ NotApplic. ❑ Received ❑
VALUATION I SOOUFCE GAS ELECTRIC PUBLIC O SEPTIC SEWAGE Ownership1 FEES COLLECTED
9• UTILITIES PRIVATE ❑ SEWER ❑ Public ❑ Private ❑
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 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 REYRASEStIDE FOR REOUIRED INSPE TIONS
SIGNATURE OF APPLI
OWNER OR GEN -� DATE CAT N_
SPECIAL APPROVA SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Utilities
Plans I PERMIT IS NONTRANSFERABLE
Exam. I I I I PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tush --�.. _ IN 180 DAYS
Building
Plumbing
Mech.0 .�
Plan Check
SEPA
Modular/
MFG.Home
PERMIT NUMBER
Other (Specify)
TOTAL $-Z� ®�
WHEN MACHINE VALIDATED IN THIS S
THIS BECOMES A PERMIT.
DATEUEDO 8 PERMIT;o. u, 9 z 2 0 0 0 0 -j-AL
t3
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APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREETADDRESS
PARCEL NO.
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
I
OWNER
PHONE
PHONE
3.--Z) C Aj ,v S�
Q-2—C., I (C. _'
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
N I 17 ((
r,
'al Z
North South East West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
4.
a rne
I
Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Dyes ❑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
Deck
Fin. Basement
Unfin. Basement
s.
TUn_
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
!•
OF NEW
❑ ALT. ❑/AD'N. ❑ RPL. ElMVE. ❑OTHER
WORK ❑ BLD.
❑ PLMB. E MECH. ❑ M.H. ❑ POOL
Certifi.ofExempt.
Required Yes❑ No❑
Number
or Variance Received Yes❑ No❑
8 DESCRIBE WORK Shorelines/ Flood Hazard Plans Required ❑
Uj 001�.� lG� V � Yes❑ NotApplic. ❑ Received ❑
VALUATION I SOOUFCE GAS ELECTRIC PUBLIC O SEPTIC SEWAGE Ownership1 FEES COLLECTED
9• UTILITIES PRIVATE ❑ SEWER ❑ Public ❑ Private ❑
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 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 REYRASEStIDE FOR REOUIRED INSPE TIONS
SIGNATURE OF APPLI
OWNER OR GEN -� DATE CAT N_
SPECIAL APPROVA SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Utilities
Plans I PERMIT IS NONTRANSFERABLE
Exam. I I I I PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tush --�.. _ IN 180 DAYS
Building
Plumbing
Mech.0 .�
Plan Check
SEPA
Modular/
MFG.Home
PERMIT NUMBER
Other (Specify)
TOTAL $-Z� ®�
WHEN MACHINE VALIDATED IN THIS S
THIS BECOMES A PERMIT.
DATEUEDO 8 PERMIT;o. u, 9 z 2 0 0 0 0 -j-AL
t3
C
C:
U
U