1983, 07-05 Permit: 83A-6113 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY , '3\ - - 113
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)4563675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. • 7 .,-I 6 ', , l
LOT BLOCK SUBDIVISION 'LEGAL DESCRIPTION:
2.
OWNER ONE PHON
MAILING ADDRESS Actual Set Backs in Feet to:
1 jC; !an !3"._ 1 GI-r,11 ,2%3L0 North I South (East West
CONTAKit LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
Commercial ID 4 * * 2 0.0 0
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑Req'd. 6 1 L L
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area 0 7— 0 5—8 3
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse b. 4 7 9.
CHANGE OF USE FROM TO Cover Deck - Uncv.Deck Fin.Basement Unf in.Basement
6.
No.Baths No.Floors IVo.Fin.Rooms No.Dwellings
TYPE NEW 0 ALT. ❑ 'N. 0 RPL. 0 MVE.
7. OF WORK
0 BLD. 0 PLMB CH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes 0 No❑
8.
DESCRIBE WORK_ f6 Shorelines/Flood Hazard Plans Required 0
OCX7 Yes❑ Not Applic.0 Received 0
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9OF
UTILITIES PUBLIC 0
PRIVATE 0 SEPTIC 0
SEWER❑ Public 0 Private 0
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 Plumbing
SIGNATURE OF / APPLICATION 7j 6.T Mach. _
OWNER OR AGENT /�%%r �Q,1(l v �1� ) DATE / �J�
SPECIAL APPROVALS SPECIAL ONDITIO S:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning Modular/
MFG.Home
Fire )-
a.cm
Prevent.
Other(Specify) C..
Engineer LU
Utilities7-
r
TOTAL $
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 7�� IN 180 DAYS Q -i Q 5 -8 3 �j l 3 z * 2 0 O 0 Ooh'JAL
Tech. DATE ISSUED PERMIT NQ. ll