1983, 03-21 Permit: 83A-2071 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
1,) SPOKANE COUNTY — DEPARTNVrEN?OF BUILDING & SAFETY2t 1
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675 83
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS y c -AAPARCEL NO.
1. c,9 3 N . 9—C,E-k)T
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. ..Te. I+1 `C_Alw -t7--‘‘CA- to WzE (cS73
MAILING ADDRESS <A eth ZIP Actual Set Backs in Feet to:
S. N-23. S
, -E) v 1 North South East I West ,: Cr - c'
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4. Commercial 0 L_ V ,-.
ADDRESS ZIP Type Const. Occupancy ❑Yes Spr❑Norte ❑Req'd i —
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area ! C,
5.
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE [ W ❑ ALT. ❑ AD,'-N. ❑ RPL. ❑ MVE.
7. OF WORK
0 BLD. ❑ PLMB. T `ECH. ❑ M.H. 0 POOL ❑ OTHER Certifi.of Exempt. Required Yes❑ No Number
or Variance Received Yes 0 No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8. WO
0D 1D 5-VO y Yes❑ Not Applic.0 Received ❑
VALUATION SOOURCE GAS ELECTRIC PUBLIEO SEPTIC 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 REVERS SIDE FOR REQUIRED INSPECTIONS / Plumbing
SIGNATURE OF�j ! ( e, $ APPLICATION '3, J - -7
OWNER OR AGENT /. "`��� DATE ' // Mech. A.f�
SPECIAL APPROVALS SPECIAL COND TIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home )-
Prevent. d
O
Engineer Other(Specify) G]
W
J
Utilities ni IT.
TOTAL $ LtJ
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. -- PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building /�' ?( IN 180 DAYS zZ. O 7 1 a * 2 � o Q a PI
14 DATE I O 2 1 — 8 5 PERMIT Il. TOTAL