1983, 01-03 Permit: 83A-0034 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY e5A - 0034-
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES— PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. r7- 144;f 4- = T"r
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER ON PHONE
eet to:
3. MAIENG AD 1RE�S lcTJ gyp,5 Actual Set Backs in'! y -7s ` `E',3 2 NorthSize of Parcel 'South [East I West
CONTRACTORLICENSE EXPIRES PPHHOONN
Zone Classification Residential❑
4. -
� �i 6j Commercial❑ !_i- * K i 'v
ADDRESS ZIP Type Const. Occupancy Sprinklered ^ x
❑Yes ❑No ❑Req'd. C �-t� l�
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area * v ` C-
5. - 7 3
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. 6 a 7
TYPENo.Baths No.Floors No.Fin.Rooms No.Dwellings
X� NEW 0 ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF WORK ❑ BLD. ❑ PLMB.2-MECH. ❑ M.H. CI POOL CI OTHER �ifi.ofExempt. Required Yes No❑ Number
or Variance Received Yes❑ No❑
8. DESCIRI76E WORK ` Shorelines/Flood Hazard Plans Required❑
IA�Y Q''C: c y rj Yes Not Applic.❑ Received ❑
VALUATIONYY__ SOOURCE GAS ELECTRIC WAPUBTER
❑ SEPT 0 Ownership FEES COLLECTED
9 UTILITIES PRIVATE❑ SEWER 0 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 othe tate or local law regulating construction or the performance
of construction.SEE RE SIDE FOR R I ECTIONS Plumbing
SIGNATURE OF / gzt
' APPLICATION
OWNER OR AGENT - DATE Mech. 7/0
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home >
Prevent. d
O
Engineer Other(Specify) v
W
J_
Utilities 7:-.0 - u-
TOTAL $
SEPA
MACHINE
Plans PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERM TTED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED l j
Buildingt k �� IN 180 DAYS DATEiSSUEDO 8 PERMIT NO."' z * 2 O. O O0 J
I�1fAL
Tech.