1984, 03-22 Permit: 84A-2497 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTME11T OF BUILDING & SAFETY g TA - 2'c1 7
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESSPARCEL NO.
1.
) 4
0 ' ' l.'. ar-47, _ 17 I
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
IICi I Ky KOr o 'TOWNSjTg
O VNER
3. _I 1► +1 (��
�' �`� PHONE l -510E5 UE5 PHONE
MAILING ADDR S , ZIP Actual Set Backs in Feet to:
I ►f _ North (South East I West
CONTRACTOR
4LICENSE E PQES P 8Size of Parcel Zone Classification Residential
4. aDL)N1N `WV�(L� vf3/f Commercial❑
`1 -. '
ADDRESS - nib, 2,06? TYpeConst. Occupancy Sprr�
Li1 '11,I ❑Yes ❑No
❑Req a.
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 Unfin.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE 'NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER .
WORK ❑ BLD. ❑ PLMB. KMECH. ❑ M.H. El POOL Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes No❑ ofa
I,
DESCRIBE WORK = ,l » �-�y,�G Shorelines/Flood Hazard Plans Required❑ f
8. WQOY ' JV' rJ Yes Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership
9 PUBLIC❑ SEPTIC❑
PRIVATE❑ SEWER❑ Public❑Private❑ FEES COLLECTED
UTILILITIES 32
c
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 F!- REQUIRED INSPECTIONS Plumbing
SIGNATURE OF / APPLICATIOI ,
r
OWNER OR AGENT , , �-% '— DATE .:)---1--- Mech.
SPECIAL APPROVALS SPIC AL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE SP,
Plan Check
Env.Health
SEPA
Planning Modular/
Fire MFG.Home
Prevent. O
Engineer Other(Specify) W '_.
J_
Utilities �,�.�
_ TOTAL $ 74,
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 IN 180 DAYS - q
Tech. i� 2 DATEISiUEc2 2 8 `t PERMl12N .9.7 5z * 2 O. 0 0 Ra-TIAL