1983, 09-14 Permit: 83A-9030 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 83.S4 X030
NORTH 811 JEFFERSON /SPOKANE,'tVASHfh1GTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES— PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. 9s– . -, 2 A‘Sd sibac (l tea. 99Z-lz
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. I yN A v L�
OWNER . S PHONE PHONE
3. dS0A) A, L `q( l
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
Ps E 2f,6" clap a t Z... North 'South East I West
CONTRACTOR / LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential 0
Commercial❑ r;
4. e �; LI * x .j
ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑Req'd• * ` • C. _.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area �r r
ti
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse c _; G
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement — 1
6. / LL `;
^
No.Baths No.Floors No.Fin.Rooms No.Dwellings
7 TYPEOANEW ❑ ALT. ❑ A ' . ❑ RPL. ❑ MVE. ❑ OTHER
WORK
CI BLD. D PLMB. ECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No El Number
or Variance Received Yes❑ No❑
DESCRIBE WORKShorelines/Flood Hazard Plans Required 0
8. //Vs�a/ o d Save WiOkokSBwry C iNA t'vAol Yes❑ Not Applic.0 Received 0
VALUATION SOOURCE GAS ELECTRIC WAPUBTER
O SSEWAL❑E Ownership FEES COLLECTED
g UTIF
LITIES PRIVATE 0 SEWER 0 Public 0 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 Building
work will be complied with whither specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel e •rovisions of any other state or local law regulating construction or the performance
of construction.SEE RE ERS=SIDE FOR REQU •ED NSPECTIONS Plumbing
SIGNATURE OF f /` DATECATION /,.., �8
OWNER OR AGENT / Mech.
SPECIAL APPR ' S SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. I DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home >
Prevent. a'
O
Engineer Other(Specify) _ C.
W
J
UtilitiesIt
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building � �\ �, IN 180 DAYS 9 `_ Q (� orf O
Tech. (kr DATEQSSUEDl 4 -8 3 PERMITM6. 0 z * 3 O. 0 U tZOIfAL