1983, 09-09 Permit: 83A-8834 Wood Stove, Chimney PLAN NUMBER APPLICATION/PERMIT PERMIT BER
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.
1. S 2t Q co \J (LA Ce-E-s-r- L
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
PH
OWN I)VA ��1^vv\CUA7--- PHONE 412-8
-ZSOCt
3. MAILING ADDRESS ' ZIIP Actual Set Backs in Feet to:
S 70 0 0 `V -A �' JT-. r (NCI(.3--7
North 'South East I West
C TRACTOR �n LICENSE EXPIRES PHONE ,� Size of Parcel Zone Classification Residential
CI��� pt , ,,"� U �� 9 Commercial❑
4. ADDRESS i 1l� ZIP Type Const. Occupancy Sprinklered
❑Yea ❑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
TYPECj NEW ❑ ALT. ❑ A N. ❑ RPL. ❑ MVE. ' ` 7
7. OF OTHER
WORK ElPLMB. ECH. ❑ M.H. Cl POOL Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ No❑
DESCRIBE WORK • Shorelines/Flood Hazard Plans Required❑
8. Votof,'7 - 5 .)E C AS e,,` ,-.,` Yes Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEW Ownership FEES COLLECTED
9 UTILITIES
OF
PUBLIC El SEPTI
PRIVATE El SEWER El 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-BEVERSE SIDE FO REQUIRED INSPECTIONS Plumbing
SIGNATURE OF �� APPLICATIC
_,[__j!�
OWNER OR AGENT-7- t ...— DATE Mech. 3o —
SPECIAL APPROVALS SPECIAL CON NS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE � Plan Check
Env.Health ,A- �L - Km Z,`�'n SEPA
Planning Modular/
MFG.Home )- .
Fire d
Prevent. V
Engineer Other(Specify) W 3
J
hL
Utilities
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
BuildingDK IN 180 DAYS ((�� QQ ' n QQ Q /I
Tech. DATE4SSUE� - PERMII�Ntl.Iz *3 O. O O ¢ORAL