1983, 03-29 Permit: 83A-2339 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY Ste'► -z.31
(/ NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. ,C4 ( \IE2C.t Gre_ r
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. INttci-awes a F1/4-- s, 612-6•- 71.(..
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
5..41 1 1f 6rtc.L-Er2... aG1t.C, North (South East I West , ?
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
Sitklevt..e
Commercial❑
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
>:saAnAE ❑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 LrJ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
❑ BLD. ❑ PLMB. VMECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No❑ Number
WORK or Variance Received Yes No❑ I
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑ I
8. \AI000CirOt)E •1.s.+1 w► /t.1� C irll vy1?. '-{ Yes❑ Not Applic.❑ Received 0
I
SOURCE GAS ELECTRIC PUBLIC❑ SEPTIC SEWAGE Ownership
VALUATION FEES COLLECTED
9. UTILITIES WATER 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 •E FOR REO t INSPECTIONS Plumbing
SIGNATURE OF J ....if,, DATE
OWNER OR AGENT � � � / Mech. 30-Ce,
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning Modular/
MFG.Home ).—
Fire a"
Prevent.
C.)
Engineer
Other(Specify)
Li
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
Building / / > IN 180 DAYS n ; 20� 3, 9 z * 3 O. 0,0 tAL
Tech. 9-:?-
q DATEISSC1�Ih2 9 —� 3 PERMIT