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1983, 09-19 Permit: 83A-9193 Wood Stove, Chimney PLAN NUMBER APPLICATION/PERMIT PERMITNUMBER SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY sik'7 I , 3 ( )} NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES STREET ADDRESS PARCEL NO. 1. 1 I� Pio-r�- t -y LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: 2. OWNERj �w ' P ONE PHONE ��✓' 3. MAILING ADDRESS V IA^` AESS �T Y / ZIP Actual Set Backs in Feet to: •5 . 1 107 K0< 9 0 3 J' North I South East I West CONTR CT 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 `l * * U �` * L1 C y CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement 6. r- * C / No.Baths No.Floors No.Fin.Rooms No.Dwellings TYPE EJ NEW El ALT. ❑ AD'N. CI RPL. El MVE. y1 ° 7 WORK CI OF BLD. El PLMB.,IMECH. M.H.El POOL ❑ OTHER Certifi.of Exempt. Required Yes No❑ Number 1 c _. -.: or Variance Received Yes❑ No❑ C ���/ Shorelines/Flood Hazard Plans Required IDDESIBE WORK 11 r/ �_ 8. C t� g'"O -'1 O(J�"r �M I Yes Not Applic.❑ Received ❑ VALUATION SOOURCE GAS ELECTRIC WATERPUBLIE SSEWIC 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 - 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 REQUIRED INSPECTIONS �J Plumbing �y SIGNATURE OF X‘171-/Ag, Q'� DPPLICATIOrn�,/� /9F3. Mech. 3 VOWNER OR AGENT meq/ DATE SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE Plan Check Env.Health SEPA Planning Modular/ MFG.Home >- Fire Prevent. 0 O Other(Specify) v Engineer LU J_ Utilities _ TOTAL $ SEPA MACHINE Plans PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERMITTED IN THIS SPACE, Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building ‘17/(:" 1� IN 180 DAYS no ' pp Tech. (q DATEQSSUEDI- 9 -8 3 PERMITM1.9. 35 * 3 0. 0 0 IOl AL