1982, 11-18 Permit: 82B-1183 Wood Stove PLAN NUMBER APPLICATIQI` !,,PERM IT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY 13 - 1 l&3
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES " 1 5
STREET ADDRESS - / 7
, I PARCEL NO.
1. N . 10:20W 1 L-,e5U AP
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. V. c� . iR �T 9,7-4---&,L%�
MAI ir ING ADDRESS I P Actual Set Backs in Feet to:
i
I 3 I( '�L!(� � _ North (South [East i West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential
`‘-- Al Commercial❑ s
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
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 'NEW El ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OFElOTHER
WORK
CI BLD. El PLMB..B(MECH. ❑ M.H. CI POOL Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8. 000 C-�-(' "j Yes❑ Not Applic.❑ Received ❑
VALUATION f SOURCE GAS ELECTRIC WATER SEWAGE Ownership
OF PUBLIC❑ SEPTIC 17 El
COLLECTED
9 ` I UTILITIES PRIVATE ElSEWER❑ 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 E FOR REQUIRED INSPECTIO,S Plumbing
SIGNATURE OF , APPLICATION G _
OWNER OR AGENT — f�r-"f 'YAW DATE ' ./ F.z Mech. 0-0 -
SPECIAL APPROVALS SPECIAL CONDITIONS: ( EE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home
CL
Prevent. C
Engineer Other(Specify) C.1
W
-J
Utilities - LL
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 1 1 1 S –8 ss)
8. 3 z * 2 U. 0
Tech. * DATETSSt1ED PERMIT/�v1tOfAL