1983, 11-10 Permit: 83B-1542 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY Sae- ;54'2.
NORTH 811 JEFFERSON/SPOKANE,_ WASHINGTONWA• 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES n
STREET ADDRESS PARCEL NO.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER1-,—.7 ,p PH FtiPHONE r' L
3.
MAILING,gDDRESS ,(��/ I �' /�-/ ZIP •
y^ Actual Set Backs in Feet to:
�-/�c�/y Y!`•`�//�- :S' o K/I/t , y' 2//j North _South East I West r
4.
CONTRACTOR. CNr�K LICENSE EXPIRES P157) ��( ' Size of Parcel Zone Classification Residential❑
/pq /(F ` {�/ ,/y x N /� g.,(� n Commercial❑
&1650Cm —5Y,itA'6 N6 V gg/74044 AifC ZI L 7 ®, 7/ Type Const. Occupancy ❑Yea Spr❑Norte ❑Req'd.
DESIGNER !15# � ``/O uo.5. PJ,ONE_✓��g New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. ADDRESS ! 5" ZIP v Main Floor Upper Floors Garage/Storage Greenhouse -
I
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 )(NEW 0 ALT. 0 AD'N. 0 RPL. ❑ MVE.
7 0 OTHER
WORK CIBLD. ❑ PLMB. ❑ MECH. ❑ M.H. ElPOOL Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ Noll
DESCRIBE WORK �A[� /� j / 17 �j j� /// HazardPlans Required 0
8. WORK,
7�// NI-- � k/ / Oaf pp11���� Yes❑' NotAppli ❑ Received 0
VALUATION SOURCEDGAS ELECTRIC PUBLIC SEPTIC❑SEWAGE Ownership FEES COLLECTED
9. UTILITIES t�O) PRIVATES❑ SEWER Public❑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 REV E SIDE R REQUIRED INS CTIONS Plumbing
SIGNATURE OF APPLICATION / /�
OWNER OR AGENT DATE /i /�/ _4g.
�� Mech. ZO.GO
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home )-
Prevent. a
O
Engineer Other(Specify) W
J
Utilities a:
3,0
.06
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
Budding Lt IN 180 DAYS :
I I 'Q
Tech. 2?' it 6DATEL�UED1{0 —8Y 3 PERMIT�Sd T 2 z' * O. 0 0 1°4-AL