1983, 07-06 Permit: 83A-6205 Wood Stove, Chimney PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER ,
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY 03ft -472(55—
C-- 72(55C NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. 1\r'Z �rtJ. Z&S4 —zc , ,
LOT BLOCK SUBDIVISION LEGAL DEZCRIPTtON:
2.
04 * * 30. 00
OWNER PHONE PHONE
3.
M CrLL. ft.) . L-kco..�rn tai.)iJ Gt:2Co-co --7.2 * 3 U 0 0 Y
MAILING ADDRESS ZIP Actual Set Backs in Feet to: A * 7
E. • u SZ.C+ C-t'i 44-2-eCP North 'South [East (West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑ 6 2 U.4 2
r��i4 r11E Commercial❑
4• ADDRESS ZIP Type Const. Occupancy Sprinklered C 7-G J-
A Mr. ❑Yes 0 N ❑Req'd. 6,4 7 c,
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 ❑/NEW 0 ALT. iJ AD'N. 0 RPL. El MVE.
7 WORK OF
P BLD. ❑ PLMB. 171/MECH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes CI No❑ Number
or Variance Received Yes❑ No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required 0
8. IYIA`-=CSN z.N/ O.H i h/l/vE-i i W c TO c,; Yes Not Applic.❑ Received 0
VALUATION SOOURCE GAS ELECTRIC p ❑
WATER SEWAGE
SEPTIC Ownership FEES COLLECTED
9. UTILITIES PRIVATE 0 SEWER❑ Public 0 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 grantingof apermit does notpresume to Building ,
P P 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 F REQUIRE NSPECTIONS Plumbing
SIGNATURE OF OWNER OR AGENT-JD l— 92 / �. DATE ATI N / ()��
1 �i� ' �� DATE / v Mech. .. 0.
SPECIAL APPROVALS ' SPECIAL CONDITIONS: (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 LL
TOTAL $
SEPA O.
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building g°'
IN 180 DAYS Q 7 '_ p �j O *3 O O 0 0 J
Tech. 7/(alfa" DATE4SSUE� _ov PERMIT 1a a 5 z iLoyAL