1983, 11-22 Permit: 83B-1920 WoodstovePLAN NUMBER
APPLICATION/PERMIT
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
STREP ADDRESS
1. �V , RE�9- ki
Ll� j4(.7
LOT
2.
BLOCK
SUBDIVISION
OWNER I
3. KO1z;'- MuCi-LC-
MAI ING ADDRESS
> Vi i LI
4.
cof�IR(�t' 1
LICENSE EXPIRES
ADDRESS
•
DESIGNER
ADDRESS
CHANGE OF USE FROM
PHONE
�•C.7:o
PHONE
ZIP
PHONE
ZIP
TO
TYPE /NEW ❑ ALT. E AD' N. ❑ RPL. ❑ MVE.
7. OFWORK ❑ BLD. ❑ PLMB. 0�MECH. ❑ M.H. ❑ POOL ❑ OTHER
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North (South
East
Size of Parcel
Type Const.
Occupancy
New Const. Valuation
Main Floor
West
Zone Classification
Residential C
Commercial C
Spr'nklered
❑Yes CNo Req 'd.
Remodeled Valuation
Upper Floors Garage/Storage
DESC C/ N9R� CJ VC,
(i JY/ ,
VALUATION
9.
SOURCE
UTILF
ITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER 0
Cover Deck
No. Baths
Uncv. Deck
No. Floors
Certifi. of Exempt.
or Variance
Total Bldg. Floor Area
Greenhouse
Fin. Basement
No. Fin. Rooms
Required Yes❑ No-'
Received Vest: No
Shorelines/Flood Hazard
Yes0 NotApplic. ❑
Ownership
Public C 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
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 INSPECT! NS
SIGNATURE OF / • .C/f� APPLICATION
OWNER OR AGENT .v . ' '' DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number
Plans Required C
Received C
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
r
011* *20.00
*20.006
A *0.00
191.92
11-22-83
2 647L9.
C
0
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE IS Erfr L ) PERMITNO. O Z *2 0.0 0 AL
c)