1984, 02-03 Permit: 84A-968 Wood Stove PLAN NUMBER APPLICATION/PERMIT P RMITNUMBER
1 SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY y 1 S
l NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEINO.
1. . l
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OW ISRj. 7Ne7 PHONE
MAIujJG ADDREss
191" FC--t4 '/9<-7,1 4,7 dual Set Backs inFeet
South. East I West
COI :::::. LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential 0
Commercial 0 a! •,''
4. ADDRESS ZIP Type Const. 'Occupancy Sprinklered ,
❑Yes ❑No ❑Reg'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. `- (.1 `
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
7
TYPE p-N€W 0 ALT. 0 AD'N. 0 RPL. 0 MVE. ❑ OTHER
WORK
0 BLD. 0 PLMB..2(MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes❑ No
DESCRIB WO Shorelines/Flood Hazard Plans Required 0
8. � � Yes❑ NotApplic.0 Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9. PUBLIC❑ SEPTIC❑
PRIVATE 0 SEWER❑ Public❑Private❑
UTILILITIES
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 Building
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
NREQUIRED INSPECTIONS Plumbing
SIGNATURE OF 97` �9 DATE
`��dJ!/ Mech. `)-
OWNER ORAGENT '/ """kkk"'�" ! ` j
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning Modular/
Fire MFG.Home d
Prevent.
O 2
Engineer Other(Specify) W
J_
Utilities fy
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
Buildingo b IN 180 DAYS ((�� w c� i o J
0 DATEIS�UED' / PERMIT N0.6, 0 z * �� 0 �dTAL
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Tech. /
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