1983, 09-13 Permit: 83A-8989 WoodstovePLANNUMBER� APPLICATION/PERMIT
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.
WORK
LOT
BLOCK
SUBDIVISION
DESCRIZ WORK
8• �j
LEGAL DESCRIPTION:
Plans Required ❑
�0 ��V
2.
Received ❑
I
I
GAS
ELECTRIC
WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
Ownership
OWNER_ ��
9
P ON
PHONE
PRIVATE 1-1
I SEWER11
3.
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
Building
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
MAI ING ADDRESSI�
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
ua t Backs n Feet to:
Mach.
OWNER OR AGENT DATE
SPECIAL APPROVALS
1 13 "Z;21L�
I�
4PHbNE
PRELIM. FINAL DATE
North South
East West
Env. Health
CONTRACTOR
LICENSE EXPIRES
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
4.
ADDRESS
ZIP
TypeConst.
Occupancy
Sprinklered
Dyes ONO
❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor
per 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
El ALT. ❑ AWN.
11 RPL. El MVE.
7.
OF ❑ BLD.
❑ PLMB. 01MECH.
❑ M.H. ❑ POOL ❑ OTHER
Certifi.ofExempt.
Required Yes❑ NOD
Number
WORK
or Varianoe
Received Yes❑ No❑
DESCRIZ WORK
8• �j
Shorelines/Flood Hazard
Plans Required ❑
�0 ��V
yes NotApplic. ❑
Received ❑
VALUATION I
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
Ownership
FEES COLLECTED
9
UTILITIES
PRIVATE 1-1
I SEWER11
public El 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
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
Mach.
OWNER OR AGENT DATE
SPECIAL APPROVALS
SPECIAL C DI NS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Planning
Engineer
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
BuildingiN 180 DAYS
1
Tech.
Modular/
MFG. Home
Other (Specify)
TOTAL $ 24�1 . I
WHEN MACHINE VALIDATED IN THI
THIS BECOMES A PERMIT.
PERMIT NUMBER
DATEIIZIJ 5 9 J PERMIA6. 8' c * !�' t' Q COITAL
L