1983, 12-29 Permit: 83B-2866 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
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
STREET ADDRESS PARCEL NO.
1. 1 ? J 14 D,NL •
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNERPHONE PHONE
3. KcN1•IEn4 uJapi
cif•-3301
MAILING ADDRESS ZIP ZIP Actual Set Backs in Feet to:
/Jr Y l f 0.3.7 North I South East I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
Commercial❑
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area ( .�. .. _i
5. U,
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• OFD BLD. ❑ PLMB./MECH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes No Number -
WORK or Variance Received Yes No El
DESCRIBE WORK 1,� ,� Shorelines/Flood Hazard Plans Required❑
8• Moo Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCEOGAS ELECTRIC PUBLICO SEWAGEEPTIC Ownership FEES COLLECTED
9. UTILITIES PRIVATE❑ SEWER❑ 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 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
GNATURE OF �(2./���� C DATE CATION L �3 Mech. •?•,9,'�
OWNER OR AGENT itt. `'X/f C
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE . Plan Check
Env.Health
SEPA
Planning Modular/
MFG.Home >-
Fire
d
Prevent.
e 0
Other(Specify) v
Engineer W
J
Utilities ;lbs T.TOTAL $ ��c!/
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
1 22 . -J .Building IN 180 DAYS 286. 6 * 20: 00o
F-
Tech. s.S- DATE ISSUED PERMIT NO. TOTAL