1983, 09-08 Permit: 83A-8740 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT.OF BUILDING & SAFETY e",-1,, -g,7
2-0
( NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
.! APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET§TREET ApDREpS `� ^kms PARCEL NO.
1.N , Z-rr2/
LOT BLOCK SUBDIVISION -t��/ LEGAL DESCRIPTION:
2.
OWNER. PHONE PHONE
3. �_ 7 .. 7I5 7
MAILI G AD RE$S Z /�/�� Actual Set Backs in Feet to:
7 - ?Ij.� ' 1 6Q North !South [East (West
CONTRR fAC,�TQR�6, LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
�(�,I Commercial❑
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
DYes OM ❑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 L NEW ❑ ALT. ❑ 9'N. ❑ RPL. ❑ MVE.
7. OFCIOTHER
WORK
0 BLD. 0 PLMB. MECH. 0 M.H. ❑ POOL Cert nice empt. Required Yes': No❑ Number
or Received Yes El No
DES RIBE WORK Shorelines/Flood Hazard Plans Required❑
$, e0 Yes Not Applic.❑ Received ❑
WATER SEWAGE Ownership t
VALUATION SOURC GAS ELECTRIC PUBLIC❑ SEPTIC❑ FEES COLLECTED
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 SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF i / /' 6 APPLICATION
OWNER OR AGENT 1 • „ : _si,• ) DATE 9/7/61—S Mech. --7x.%9
SPECIAL APPROVALS -PECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning Modular/
MFG.Home ).-
Fire
Fire a
Prevent. c
Other(Specify) v
W
Engineer J
Utilities I'
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 COMMENCEDv.
}
Building / j� IN 180 DAYS DATE I ISSUED 8 u 5
PERMIT NO 4 ( o * 2
�h U 0
( AL