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1983, 12-27 Permit: 83B-2806 Wood Stove PLAN NUMBER APPLICATION/PERMIT P RMIT NUMBER SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY 05S ---7606 NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES STREET ADD RESS U N {v P rRCE:NO. 1 LOT BLOCK SU DIVISION� LEGAL DESCRIPTION: 2. OWNER PHONE PHONE 3. [— 't' L p& Jo. ) 612A_4418 MAILING ADDRESS ZIP / Actual Set Backs in Feet to: �y—5irvi — 99 Z©G� North 'South East I West CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential Commercial❑ 4. 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. ❑ MVE. 7. OF THER WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL aVarianExempt. Required YesD No❑ Number Received Yes No❑ DESCRIBE WORK weep \) _ C _7 _ ►Pl YesDinesl lood otApplic.rd0 Plans Required❑ 8. e,.7-(7)\) _ `� ft�� Yes❑ Not Applic.❑ Received ❑ VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED 9OF UTILITIES PUBLIC El PRIVATE ElSEPTIC❑ 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 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 REVE• • ,•- ,e E FOR REOU,'ED INSPECTIONS Plumbing SIGNATURE OF y / / APPLICATION, ez® OWNER OR AGENT i AAI L DATE Mech. SPECIAL APPR• ALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) C) PRELIM. FINAL DATE Plan Check Env.Health SEPA Planning Modular/ MFG.Home Fire Prevent. C3 Engineer Other(Specify) 9 J Utilities • ✓ fi: 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 A IN 180 DAYS . Tech. / ail/ DATEISZED 2 7 — 8 3 PERMITI1c.) Q O. z 6/ o * 2 1301�L