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1983, 10-25 Permit: 83A-869 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 1. STREET ADDRESS a� Fiwc a PARCEL NO. LOT 2. BLOCK SUBDIVISION OWNER 3 SrhvtoL L I'r(LE�c�c c� MAILING ADDRESS N • 2 - PHONE PHONE LEGAL DESCRIPTION: ZIP etek Actual Set Backs in Feet to: North (South [East I West CONTRACTOR 4.VVL� ADDRESS DESIGNER 5. ADDRESS LICENSE EXPIRES PHONE Size of Parcel I Zone Classification Residential ❑ Commercial ❑ ZIP Type Const. Occupancy Sprinklered Yee ❑No ❑Req'd. PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area ZIP Main Floor Upper Floors Garage/Storage Greenhouse CHANGE OF USE FROM 6. TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement 7. TYPEOF I/ NEW ❑ ALT. ❑%`D' N. ❑ RPL. ❑ MVE. ❑ OTHER WORK ❑ BLD. ❑ PLMB. MECH. ❑ M.H. ❑ POOL No. Baths No. Floors No. Fin. Rooms No. Dwellings Certifi. of Exempt. or Variance Required Yes ❑ No❑ Received Yes No Number 8. 9. DESCRIBE WORK LA-) o c2 E VALUATION SOURCE UTILITIES Shorelines/Flood Hazard Yes❑ NotApplic. ❑ Plans Required ❑ Received ❑ GAS ELECTRIC WATER PUBLIC 0 PRIVATE ❑ SEWAGE SEPTIC ❑ SEWER ❑ Ownership Public 0 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 REVERSE SIDE FOR REQUIRED INSPECTIONS SIGNATURE OF OWNER OR AGEN SPECIAL APPROVALS PRELIM. FINAL DATE Env. Health Planning Fire Prevent. Engineer Utilities SEPA Plans Exam. Building Tech. APPLICATION DATE ECIAL CONDITI S: (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 $ _-o'_ PERMIT NUMBER WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATEfS1UED2 5 _ 8 3 PERMIT Nd. 6, 9 z * O' 0 0 �O�AL