1983, 11-14 Permit: 83B-1619 WoodstovePLAN 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
STREET ADDRESS PARCEL NO.
1. S. /5'17 .5Hf4MP-0r_1_ S
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER
PHONE
PHONE
RayL
2 -Zgg5
3.
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
S_ t5L77 S 1fAn1 ck-
o 3 -7
North South East
wast
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
4.
ADDRESS
ZIP
Type Const. Occupancy
Sprinklered
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor 'UpperGarage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Oedc
U__ Deck
Fin. Basement
Unfin. Basement
6.
-
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE a-1 EW ElALT. ElAD' N. ❑ RPL. ElMVE.
7.
(PF ❑ OTHER
WORK El BLD. ❑ PLMB. L�IGECH. ❑ M.H. El POOL
Certifi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
8.
DESCRIBE WORK
'
Shorelines/ Flood Hazard
Plans Required ❑
woe N 5TA �o
Yes❑ Not Applic. ❑
Received ❑
VALUATION
I SOOURCE
GAS
ELECTRIC
pUBWATER
SEPTAL O
Ownership
FEES COLLECTED
9•
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
1 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-
Building
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
Plumbing
SIGNATURE OF�� / f APPLICATION
(1 '_ DATE Ille-i -' 8�
00
Mech.
OWNER OR AGENT
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PERMIT NUMBER
X38- 1E i9
PRELIM. FINAL DATE
Env. Health
SEPA
Planning
Modular/
Fire MFG. Home >_
CL
Prevent. oG C
Engineer
Other (Specify) V
W
J
Utilities
W
TOTAL $ --
SEPA
MACHINE
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERM TTED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech. DATEISJUE01 4 -- 8 3 PERMIT t- L 9 0 * 3 0, Q 0 JAL