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1984, 01-27 Permit: 84A-783 Wood Stove
PLAN NUMBER APPLICATION/PERMIT PE_RM ITNU^ SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY ` a3 NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES STREET AD RESS T4 PARCEL NG_,,, 1. LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: 2. OWNER PHONE P •3. n w'NI fL( --i i , r, 463 MAILING ADDRESS ZIP Actual Set Backs in Feet to: North South [East I West CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classif ication Residential 0 Commercial 0 4. ADDRESS ZIP Type Const. Occupancy Sprinklered ❑Yes ONo ❑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 ,[VEW 0 ALT. 0 AD'N. ❑ RPL. 0 MVE. 7 ❑ OTHER WORK 0 BLD. 0 PLMB.`4MECH. ❑ M.H. 0 POOL Certifi.of Exempt. Required Yes No❑ Number or Variance Received Yes No E1 8. DESCRIBE WORK �v©O c�TT`r Shorelines/Flood Hazard Plans Required❑ v� V V Yes Not Applic.❑ Received 0 VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED 9. OF UTILITIES PUBLIC❑ PRIVATE❑ SEPTIC❑ SEWER❑ Public 0 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 SIGNATURE OF / - �: APPLICATION //7„,-7� Oi OWNER OR AGENT 7- /� - %�- DATE /� ((( Mach. GC!• SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) tP LE IM. FINAL DATE Plan Check Env.Health " SEPA Planning Modular/ 4 Fire MFG.Home d ; Prevent. . O ' Engineer Other(Specify) W J_ i� f� Utilities Y_� _ TOTAL $ 26 SEPA WHEN MACHINE VALIDATED IN THIS SPACE, Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT. Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building A ,, 67 IN 180 DAYS n 11 . 7 8Q 3 z d o Tech, DATEUSS� 7 -8 4 PERMIT NO. , * 2 0.0 0 IdTAL