1983, 08-04 Permit: 83A-7381 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY iq" l
C..---- 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. 4/115 514NOI LANI> r , 7 3 $ C -`=
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 11 `, _C
OWNER PHONE PHONE -- 6 a 7 0
3. srE\iR aUTt-t /ziv-333r✓
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
.5. 4115 ,$uND 'IUP 9Y206 North 'South [East I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4. SAME Commercial❑
ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
J. ADDRESS ZIP Main FloorUpper 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 YEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7• OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ®1 ECH. ❑ M.H. ❑ POOL o�arianExempt. Required Yes❑ No❑ Number
Received Yes Nor]
DESCRIBE WORK Shorelines/Flood Hazard Plans Required CI
8• IA! 00 S vff.- /NSTnu_inM4 Yes NotApplic.El Received El
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE
OF PUBLIC❑ SEPTIC❑
Ownership FEES COLLECTED
9• UTILITIES PRIVATE❑ SEWER❑ Public❑Private El
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 wheth-r specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the p , i:ionsidiany other state or local law regulating construction or the performance
of construction.SEE REVERS I" • :4,1 •U ' a I PECTIONS Plumbing .
SIGNATURE OF -- _ 4 APPLICATIQN l'. c y'r vw I
OWNER OR AGENT DATE ` A ' 7 ' Mech. ID je
SPECIAL APPROVALS PECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTIC-) I
Plan Check i
PRELIM. FINAL DATE I
Env.Health
SEPA I
s
Planning
Modular/ t
MFG.Home
Prevent. /SStAg. ; 00
C a
Engineer
Other(Specify) 'iv J
Utilities Z
- TOTAL $ —_Q-
SEPA
t
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT. I
PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED (� Q n p j
Tech mg 3Z-' "71g., IN 180 DAYS DATE ISVUEDJ 4 -8 3 PERMII7Nd.o. 1 z *2 O.O 0 &AL
T�3 t