1982, 12-21 Permit: 82B-2126 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY BZ--E5 ' -k-,<.
q ) NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
r APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET DRESS PARCF,L NO.-,
1. E. (4:-" A-- i Cs r tA
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
Rt
3 t3EA C -L v.4,Et\? 534--tZzB
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
/E..-, 6:::3%4c- ccyr t-1 a North 'South East l West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
OJ p, y� Commercial❑
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
it•M+` ❑Yes Ohio ❑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 6d NEW ❑ ALT. ❑i4D'N. ❑ RPL. ❑ MVE.
7 WORK ElBLD. ❑ PLMB. MECH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes❑ No❑
8. DE RI BE WORK Shorelines/Flood Hazard Plans Required❑
CrJ s ro UE Yes Not Applic.❑ Received ❑
VALUATION SOOURCE GAS ELECTRIC WATER SEWAGE PUBLIC❑ SEPTIC❑ 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 OFOWNER OR GENT CC- n � \Q C _ �QStadV1 DATECATI(JTJ �� �`�� Mech. `c:c,
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home )-
fl-
Prevent. 0
O
V
Engineer Other(Specify) ul
...t
Utilities r
TOTAL $ .0-c210
SEPA
MACHINE
Plans PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERM TTED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Budding RP- 12fZ IN 180 DAYS
1.2,-� 8
� 6 * 2 O. O O TcDATEEDln PERMIz for-AL
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