1983, 01-10 Permit: 83A-0187 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTIVIENT,OF BUILDING &SAFETY 2 - f:7I e)7
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1. STREET ADDRESS S. 1 5. / pR a 3, e s PARCEL NO.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNE.Li D PHONE —, PHONE
,'
j eiy .4, fv/ Tt- 4i2 i'l6,4
3.
MAILING ADDRESS IRA a /6 /� 0 f g `;l5 7 ZIp Actual Set Backs in Feet to:
�,/ (/ �'( /V V North South East I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification (, 4 * * 2 C 0 0
5 0t € Residential❑
�./" Commercial❑
4. * C C 0 Q
ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑Req'd. 11 * n l o
n
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
1e
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse - 0; 1 — 1 0-0 3
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement = 6 4 %
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE .E NEVA/ ❑ ALT. 7N. ElRPL. ElMVE.
7. OF
WORK ❑ BLD. ❑ PLMB. CH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes No CI
8. DESCRIBE WORK '7-�S-'T %/ /,,•O c v�Al./may S'To v Shorelines/Flood Hazard Plans Required❑
.rF- 6 6/ 6L/c) Yes❑ Not Applic.❑ Received ❑
VALUATION SOOURCE GAS ELECTRIC PUBLIC WATER SE SEWAGE
Ownership 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 grantingof apermit does notpresume to Building
P P 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 SI OR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF APPLICATION 7
OWNER OR AGENT s\N `�.i>\ DATE \" � Mech. _-
SPECIAL APPROVALS PE L ONDI&)NS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home ),
Prevent. a.
0
Engineer Other(Specify) v
W
.J
Utilities LL
- TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building t IN 180 DAYS ((�� 1 1 p 1 Q
Tech. i
0
DATEYS*UEDL O _8 3 PERMIT N®. z * O' O 0 4�TAL