1983, 09-13 Permit: 83A-8975 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY ck " 6,7,
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
0,
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS NO.
L
1. - I -1 I'I
LOT BLOCK SUBDIVISION Z LEGAL DESCRIPTION:
2.
OW ER 4 00,,,L,I, 7i ers_r,r__
PHONE PHONE
., _. 1,‘:::2,
3.
MALNG AQDjaESS le, I . j ,� i� North Set Backs in(eet to:
East (West
COONNTC CT R +(T LICENSE EXPIRES PHONE Size of Parcel (South Zone Classification Residential EI
4. ADDRESS���j ZIP Type Const. Occupancy Sprinklered
❑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 Unf in.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF WORK ❑ BLD. ❑ PLMBCH. ❑ M.H. 10 POOL ❑ OTHER Certifi.of Exempt. Required Yes El No❑ Number
or Variance Received Yes❑ No❑
DESCRI E WORK / Shorelines/Flood Hazard Plans Required❑
8. DUB f°y 6 Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 OF
UTIPUBLIC El SEPTIC CIPublicCl Private ElLITIES PRIVATE ElSEWER❑
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 11 APPLICATION
•
OWNER OR AGENT ‘vim. N. . A DATE s 1 0"2� � Mech. a
SPECIAL APPROVALS S' bAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home
Prevent. 0
O
Engineer
Other(Specify) v
W
J_
Utilities ZC LT-
TOTAL
TOTAL $
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
Building �/ IN 180 DAYS 'l (� �'" l p
Tech. //I'�, DATL�ISdUFDI. 3 —8 3 PERMITNp.. TOTAL
(� «( 8 . 52 *2aono