1983, 10-14 Permit: 83B-437 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
4. ADDRESS ZIP Type Const. jcuPancY
STREET ADDRESS
19317 E. 4th Greenacres,Wa. 99016
LOT BLOCK SUBDIVISION
15 21 Corbin add. to Greenacres
PARCEL NO.
OWNERtpper Columbia Mission Sd'PNEy of SD'PwPustee fo
15 LLOYD F 1-TanGnn 926--6403 ` '•ZJ fc /
MAILING ADDRESS ZIP
Same As Ahotie
CONTRACTOR
LICENSE EXPIRES
LEGAL DESCRIPTION:
The East 165.12 feet of lot 1
n blk. 21 of Corbin Add. to Greenacres.
PHONE
Actual Set Backs in Feet to:
North (South
East
Size of Parcel
1 n317 F u areenarres, Wash
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
PHONE
ZIP
TO
TYPE ❑ NEW E ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF El OTHER
WORK ❑ BLD. ❑ PLMB. E MECH. 7 M.H. ❑ POOL
DESCRIBEOR
8. KfiK
cQd
VALUATION
9.
SOURCE
F
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER E
New Const. Valuation
Main Floor
West
Zone Classification
Residential J
Commercial ❑
Spr'nklered
FlYes LNo LReq'd.
Remodeled Valuation
Upper Floors Garage/Storage
Cover Deck
Total Bldg. Floor Area
Uncv. Deck
No. Floors
Certifi. of Exempt.
or Variance
Shorelines/Flood Hazard
YesL Not Applic.
Ownership
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
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
SIGNATURE OF C APPLICATION
OWNER OR AGENT Serr ± . orAtFerporation
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
IL
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Fin. Basement
Greenhouse
No. Fin. Rooms
Unfin. Basement
No. Dwellings
Plans Required : l
Received
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
�! * *20.00
*20006
*0.00 S
43.68
10-14-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
i0 -14-c5
DATE ISSUED
Q 37 0
PERMIT NO. T J 1 2
* 2 0.0 4ie,t