1983, 12-19 Permit: 83B-2620 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY e>213' 2-6,Zo
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO '"AKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. E. 12005 - 8th
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
Charles Warren 924-3872
3. MAILING ADDRESS ZIP Actual Set Backs in Feet to:
E. 12005 - 8th Spokane, WA 99206 North 'South Ifast I West
CONTRACTOR LICEN E PIRES PH Size of Parcel Zone Classification Residential❑
4 Valley Fireplace 1//84 9ZZ-2780 Commercial❑ q. ; I C;
ADDRESS ZIP Type Const. Occupancy Sprinklered a ;.) v
E. 16610 Sprague Ave. Veradale, WA 99037 ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area r'.
5 Contr. License #VALLkF-177CG -
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse `
(-' — 5
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement
6. /, 7
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ZNEW D ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7• OF ❑ OTHER
WORK
El BLD. ❑ PLMB. 12/MECH. ❑ M.H. El POOL Certifi.of Exempt. Required Yes': No❑ Number
or Variance Received Yes No
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8• Installation of Arrow 1800 stove and chimney pipe. Yes❑ NotApplic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER PUBLIC❑ SEPTIC G❑ Ownership FEES COLLECTED [I
9 UTILITIES PRIVATE❑ SEWER❑ 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 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 I FOR REQU41IRED SPECTIONS Plumbing
SIGNATURE OF 1/ APPLICATION 7 t' 24
OWNER OR AGENT \ _( = .( ll a�/'`f) '�/)"(-1 P.l DATE I J / Mech. ,
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home >,
Prevent.
O
Engineer
Other(Specify) c...1
W
J_
Utilities IS_Q> W
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 8
Building S,
I' f� (1 IN 180 DAYS Q
DATE ED' 7 — PERM IT4DIL
2, 0 * 2 0, ZIDTAL
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