HomeMy WebLinkAbout1982, 12-03 Permit: M82B-1601 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
PARCEL NO.
STREET ADDRESS
1.
LOT
2.
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
3.
OW EN ' 1F A
MAILING ADDRESS
12-.I ( 2
P ON �7
737f / i
PHONE
4.
CONTRAC[QR/;
LICENSE EXPIRES
ZIP
HONE
Actual Set Backs in Feet to:
North !South [East l West
Size of Parcel 1 Zone Classification
Residential ❑
Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes 0 N ❑ Req 'd.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE-E3"NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7- OF �
WORK ❑ BLD. ❑ PLMB..21 MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes No CI
Number
8 DESCRN C2 K9
Shorelines/Flood Hazard
Yes Not Applic. ❑
Plans Required ❑
Received ❑
VALUATION
9.
SOURCE
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
Ownership
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
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 th= provisions of any .they -tate or loc- law regating construction or the performance
of construction. SEE REV 7.1;. _ 1.Ji 'F RE • IR 1► INSPEC ONS
SIGNATURE OF
OWNER OR AGENT
PLICATI
ATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
I2 -4Z
sCIAL C 91bITIONS: (SEE R: VERS
FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL
7
PERMIT NUMBER
0'24 -- ! () I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE S UEdJ 3 - 8 2
PERMITINO. O.1 Z * 2 O, 0 0 QOIrAL