1983, 09-07 Permit: 83A-8685 Wood StoverLAN NUM=ri I ArrL IIIA I IUI"/ rC.KMI
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
STREETADDRESS PARCEL NO.
i. �r Q(9 4--T
2. LOT BLOCK I SUBDIVISION LEGAL DESCRIPTION:
OWNER ",-,jP ONE ��' PHONE
If+
4. � "
ADDRESS
DESIGNER
5.
ADDRESS
LICENSE EXPIRES
V `J North v- - South East West
PHONE Size of Parcel Zone Classification Residential ❑
Commercial ❑
ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑Req'd.
PHONE New Const. Valuation I Remodeled Valuation I Total Bldg. Floor Area
ZIP I Main Floor I Upper Floors I Garage/Storage I Greenhouse
CHANGE OF USE FROM
TO
Cover Deck Uncv. Deck
Fin. Basement Unfin. Baser
6.
Baths
Floors
No. Fin. Rooms
No. Dwellings
TYPENo.
NEW 11 ALT. ❑ A��D'N. ❑RPL. ❑ MVE.
[No.
!• OF ❑OTHER
Certifi.ofExempt.
Required Yes❑ No❑
Number
WORK C3BLD. ❑ PLMB.0 MECH. ❑ M.H. ❑ POOL
or Variance
Received Yes No❑
DESCRI E WORK\ /
8•
Shorelines/Flood Hazard
Plans Required ❑
Q� G''1-0 V
Yes❑ Not Applic. ❑
Received ❑
VALUATION
9
SOOUFCE
GAS
ELECTRIC
pU8 IC ❑
SEPTIC
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑Private ❑
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-
Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SID FOR REOUI ED INSRgCTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
Mech. C?
SPECIAL
APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTI E)
PRELIM.
FINAL
DATE__•
j
Plan Check
Env. Health
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Other (Specify)
2 v
Engineer
Utilities
TOTAL $ Ly 6
SEPA
PERMIT IS NONTRANSFERABLE
WHEN MACHINE VALI DAT
THIS BECOMES A PERMIT.
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
(� 9 _
DATE ISSUED • 0 1 — 8
Building
Tech.
�
Ft=HMII NUMbt=H
04 *20.00
*20.00
A *0.00 n
868.(1.2
09-07-83
z 6,479.
$68,52 *20,00° 1--jPERMIT N . TOTAL
A
A
C
C:
LL
LL