1983, 05-09 Permit: 83A-3797 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY A - -`1ct-1
NORTH 811 JEFFERSON /SPOKANE,WADI IINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. ,i"Z(60€2 'Z'I'P U q U
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: * C
2. A
OWNER PHONE PHONE
3. GAce -( ,( k.c se.. ccato-et??�- 379,E :-
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
S • 1Z —7...%/9 � Qt Sp North 'South [East I West v - 0 9-8 3
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑ c 6.4 7 9
4. Commercial❑
ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes 0N ❑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 ,f 'NEW ❑ ALT. D D'N. ❑ RPL. ❑ MVE.
7 WORK ❑ BLD. ❑ PLMB. MECH. ❑ M.H. I=1 POOL CI OTHER Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes❑ No❑
,DkSCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8' KI 004ThcA rz./Q i ice)(; CZ -co Yes Not Applic.❑ Received ❑
VALUATION SOURCEDGAS ELECTRIC PUBIIC O SEWAGE
E Ownership 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 0 ' APPLICATION
.�
OWNER OR AGEN ' -v ._AL/ :./_ate DATE Mech. ZG►a.
SPECIAL APPROVALS SPECIAL COND TIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home
Prevent. a
O
Engineer
Other(Specify) V
W
J_
Utilities LCL
TOTAL $ .6)..
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERMIT.
Exam.
Building 5�R PERMIT IS NULL AND VOID IF WORK IN 180 DAYS HAS NOT COMMENCED z 7 o O J
Tech. .. - e DATE I@SE)ED 0 9 —8 3 PERMIT / 9.7 z * 2 O.O n o i._L