1983, 12-19 Permit: 83B-2614 Wood StovePLAN NUMBER APPL ICAT ION /PERMIT
I 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
STREETADDRESS�" PARCEL NO. '
�7 L� �Ur—.� ��
LOT_L
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
I
O NERPHONE
VIZ i✓�
ter.
PHONE
3. �_
MAILING ADDRESS ,s
ZIP
Actual Set Backs in Feet to:
el l & I'7 7� 3
North South East
West
CONTRACTOR LICENSE EXPIRES
N
Size of Parcel
Zone Classification
Residential
Commercial ❑
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
y :,
C, .
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor area
5.
ADDRESS
ZIP
Main Floor
Upper Floors
GaragelStorage
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 .P'FIEW ❑ALT. 11 AD'N. ❑RPL. ❑ MVE.
-
7. OF❑ OTHER
empt.
Required
Yes❑ No
Number
WORK ElBLD. ElPLMB. 0MECH. ❑ M.H. ❑ POOL
oCrVariance
Received
Yes❑ No❑
8 DESCRIBE WORK�� � G��� ,
Shorelines/ Flood Hazard
Plans Required Ll
Yes Not Applic. ❑
Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership
OF PUBLIC ❑ SEPTIC C]
FEES COLLECTED
FEES
9 ❑Private ElUTILITIES PRIVATE ❑ SEWER El
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
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE DE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATIOIVi��/ �!ZY
oo��
Mech. -;50.DATE
OWNER OR AGENT
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Engineer
Other (Specify)
Utilities
TOTAL $
SEPA
THIS SPACE,
MACHINE IN
Plans PERMIT IS NONTRANSFERABLE
HEIS BECOMES A PERM TTED
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
BuildingIN 180 DAYS
Tec
DATE j�ED�
tALPERMIT d L 4 o 0
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