1984, 03-02 Permit: 84A-1800 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER •
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY S4-A--1500
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCF L NO. %
1. e. \tit? I1rµ
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. -- Atrc,L.- --6 iLc4-Ly cc-24-6. -. .
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
£. I‘Zl 0 i Com'.' q 42eee. North ISouth East I West
CONTRACTOR • LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential 0
• rt".C Commercial 0
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
..ilarnE ❑Yes ❑No ❑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 Unfin.Basement
6.
/ No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ti'hIEW 0 ALT. 0 9,N. 0 RPL. ❑ MVE.
7 WORK
0 BLD. 0 PLMB. MECH. 0 M.H. 0 POOL 0 OTHER Certifi.of Exempt. Required Yes❑ No❑ Number
7or Variance Received Yes Non
DESCRIBE WORK Shorelines/Flood Hazard Plans Required 0
8• � Tt�� Yes❑ Not Applic.0 Received 0
VALUATION SOOURCE GAS ELECTRIC WATER SWAGE PUBLIC ID ❑ Ownership FEES COLLECTED
9 UTILITIES PRIVATE 0 SEWER 0 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 SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF j') APPLICATJON •
OWNER OR AGENT X Zl 14 DATE J� 3 "z��` Mech. :20'CO
SPECIAL APPROVALS SPECIAL COND#IONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular!
Fire MFG.Home
d
Prevent.
O
Engineer Other(Specify) ti
W
J_
Utilities LL
TOTAL $ fib.CO
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
Buildingu z *I N 180 DAYS "' qq 1 Ujj nn
Tech. C - 3 2 DATE FnSSUMO 2 —J Q. PERMIT i d. • 2 a u
a TOTAL