1983, 09-26 Permit: 83A-9485 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY 8-SA cly8_
c, NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. Uere-f3 oc) Ier-� 92x.-8t(03
MAILING ADDRESS ZIP Actual Set Backs In Feet to:
' j(1 S E SA (-1-MS-E, R-"( North 'South East I West
CONT CTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential 0
A yv\;'G- Commercial 0
4. ADDRESS ZIP Type Const. Occupancy Sprinklered C, 4*
❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. f:
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
C' LtA. D
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement '` -- r
6.
� � No.Baths No.Floors No.Fin.Rooms No.Dwellings s`: �l
TYPE DYNEW ❑ ALT. ❑_ A/Q''N. ❑ RPL. ❑ MVE.
7. OF WORK
0 BLD. 0 PLMB. ECH. 0 M.H. 0 POOL 0 OTHER Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes 0 No E]
8. DESCRIBE W RK Shoor-1-f)0e.i; Yes❑elines Fllood ApNotpic.Hlazar❑d Plans Required 0
Received 0
uvoo
VALUATION SOOURCE GAS ELECTRIC PUBLIC WATER EWIC❑ Ownership FEES COLLECTED
9.
UTILITIES PRIVATE❑ SEWER❑ 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 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 - ••• onstruction or the performance
of construction.SEE REVERS IDE FO•_• .•1L•ED INSP
_-..►�11 Plumbing
SIGNATURE OF f 9
' APPLICATION tYi Z��P (83 Mech. 7
OWNER OR AGENT
SPECIAL APPROVALS SPECIAL CONDITION AEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home
Prevent. C
Engineer Other(Specify) v
W
J
Utilities —
LL
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. i PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED �� p / Q Q /� Q
Building mo IN 180 DAYS DATE ISSUEb2 u u PERMIT IQt7? 8.5 z * 2 O�O OTO AL
Tech. 4,