1983, 12-29 Permit: 83B-2846 WoodstovePLAN NUMBER APPL I(CAT ION /PERMIT PERMIT NUMBER
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.
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
OW19ER.
P ONE
PHONE
J
t5�,. L" p
80 1
3.
MAI ADDRESS
IP
Actua Set Backs in Feet to:
/
North South East West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential F-14.
Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req 'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
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 NEW ❑ ALT. ❑ AD' N. ❑ RPL. El MVE.
% OF ❑OTHER
Certif I. of Exempt.
Required Yes❑ No❑
Number
WORK 11 BLD. ElPLMB.�MECH. ElM.H. 11 POOL
or Variance
Received Yes❑ No❑
DESC
8
IBE WORK
Shorelines/ Flood Hazard
Plans Required ❑
otvv d 5
Yes[] Not Applic. ❑
Received ❑
VALUATION
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC C1
SEWAGE
SEPTIC El
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-
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
SIGNATURE OF APPLICATION
OWNER OR A G E N — DATE
SPECIAL APPROVALS PECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building Imo/
Tech. IN 180 DAYS
c
Building
Plumbing
Mach.
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
�7 Q •
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEISSD2 0
UE ) PERMIT(NO'. 4, 6 z
*20,DOft'rAL
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