1983, 02-03 Permit: 83A-813 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY
' ' l NORTH 811 JEFFERSON/SPOKANE;WASFAINGTON 99260/(509)456-3675 93a1; .. Q>1�
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. E. . 1cam; zN�
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. . * C'
OWNER/� PHONE PHONE
11'1. o .n MCDOt .9 46-7=7ez-� 4 c \.
3. MAILING ADDRESS ZIP Actual Set Backs in Feet to: ,J; k ;
E.76l-b %CAE-Ln : 6?.,t-I..4-c•-+-1 ,qct7..s>? North 'South East I west
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑ is I.
—
Commercial❑ • (` L_ . .1 J
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑Req'd. 6 4 7 y>
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
J. -
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 ^/EW ❑ ALT. D'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK CI BLD. ❑ PLMB. MECH. ❑ M.H. ❑ POOL CeVai. Exempt. Required Yes No❑ Number
or Received Yes No❑
D SCRI33E WORK Shorelines/Flood Hazard Plans Required❑
8. GYM �-.(-6 v E Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 OF PRIVATE❑ SEPTIC 0
SEWER❑ Public❑Private CI
-
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 an • her state or local law regulating construction or the performance
of construction.SEE REVERSE SIDE FOR - - • ED PEC ION Plumbing
SIGNATURE OF APPLICATION / /
OWNER OR AGENT DATE _]t`__— -� Mech. 4. ?l�,(
50
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning Modular!
MFG.Home >-
Fire a
Prevent. 0
LI 1
Engineer Other(Specify) NJ t
J
LL
Utilities
-an-
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. j� //2/ PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCEDB (� R R 1 a
Tech ung J �/✓J IN 180 DAYS DATE ISSUE O I' .1 PERMIT NO. 8 1.3 Z * 2 0. U L0