1983, 09-02 Permit: 83A-8559 Chimney, Woodstove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY gs A - Ssq
/ NORTH 811 JEFFERSON/SPOKANE,WASHINGTc 199260/(509)456-3675
c APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO. `'
1. C-.11.02.0Z O 04..t..04W N4 * .,
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. x .
OWNER PHONE T'- PHONE
3. N.)IV%-5 LES C tu(.., cae, '423 a -0728
MAILING ADDRESS ZIP Actual Set Backs in Feet to: —
€ , lCv`tc O AULE 1J LL)P.,/ act C 3'7 North 1South East }west
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential 0 L. /
G�.' .nni; Commercial❑
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
AMG ❑Yes 0N ❑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 Unfin.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE NEW ❑ ALT. 0 AD'N. 0 RPL. 0 MVE.
7 WORK 0 BLD. 0 PLMB. i'MECH. 0 M.H. 0 POOL ❑ OTHER Certifi.of Exempt. Required YesO NoD Number
or Variance Received Yes❑ Non
'rrDESCRh3E WORK . Shorelines/Flood Hazard Plans Required 0
s. t� NR LIit+MA)E1 t ' tOUE Yes❑ Not Applic.0 Received 0
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9. UTILITIES
PUBLIC❑ SEPTIC❑
PRIVATE 0 SEWER❑ Public 0 Private 0
_
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 SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF r APPLICATIQN /
OWNER OR AGENT'? =�.A - —�� - DATE Y �l Z/? 3 Mech. BO,c0
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REV RSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home }.
Prevent. O.
O
Engineer Other(Specify) V
NJ
J
Utilities u-
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
BuildingCV / IN 180 DAYS w Q n
Tech. DATE IiS�ED 0 2 —8 3 PERMIT N05 5.9 5 * 3 a 0 04)14,L