1983, 12-06 Permit: 83B-2275 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY 5'3 15271j
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET RESS PARCEL'FIO.
1. e 12 cad jtJ lqt.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PH NE PI-1_53N.
3. MAILING ADDRESS AZIP Actual Set Backs in Feet to:
S .. 13 O e7 LI' J 14(5.14<-7 North 'South East I West
CO gIACJmLICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential
Commercial❑
l
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 ` . '
r
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 L17 NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. ❑ OTHER
WORK ❑ BLD. ❑ PLMB. [1VIECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes No❑
DESCRIBE WORKJ Shorelines/Flood Hazard Plans Required❑
8. �,OU' G\ Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
OF PUBLIC❑ SEPTIC❑ �
9 UTILITIES PRIVATE❑ SEWER❑ Public❑Private❑
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 REVERSE SI i) FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF ' ` L3OWNERORAGENT JII '( �� /K .DATE Mech. �'`
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home a
Prevent.
O
Engineer Other(Specify) W
Utilities - LT-
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED 1 L5 �} n
Building i',,� IN 180 DAYS DATE SSUED 6 _ PERMI �.�' z * 2 tI` 0 0 + AL
Tech. /�