1983, 02-14 Permit: 83A-1017 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
n) 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
a
STREET ADDRESS PARCEL NO.
1. E.. 1 Q 7.x.3 17Lr11
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. , y
OWNER PHONE PHONE
3. MAILING ADDRESSZI Actual Set Backs in Feet to:
-. 14-7.-1.---, t)Z `„3 Norm 'soutnEast wast
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential r
A v‘nE Commercial 0
4. ADDRESS ZIP Type Const. Occupancy Sprinklered 1 1
.a~'•E ❑Yes 0N ❑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 0 ALT. ❑ AD'N. 0 RPL. ❑ MVE.
7 WORK
0 BLD. 0 PLMB. I�'MECH. 0 M.H. 0 POOL ❑ OTHER Certifi.of Exempt. Required Yes No Number
or Variance Received Yes No
DDS(]RIB WORK Shorelines/Flood Hazard Plans Required❑
8. V b0j`lOUE Yes NotApplic.❑ Received ❑
VALUATION SOOURCE GAS ELECTRIC PUBLICO SEPTIC❑ Ownership FEES COLLECTED
9 UTILITIES PRIVATE 0 SEWER❑ Public❑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 � / `/- APPLICATIQN
OWNER OR -� � ��` DATE � Z. /i 4103 Mech. '�4W.2
SPECIAL APPRQQ/ALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
_ SEPA
Planning
Modular/
Fire MFG.Home
Prevent. a
O
Other(Specify) v
Engineer W
J
Utilities W
TOTAL $ me—
SEPA
MACHINE
Plans PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERMITTED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building r yl DATE IN 180 DAYS 9s —E� 4 -8 3 PERMIT .]N 1.7 Z * 2 0. 0 ° T
L !�/7