1982, 12-27 Permit: 82B-2227 Wood StovePLAN NUMBER APPL ICAT ION /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 ,.{j PARCEL NO.
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
Env. Health
OW R
PHONE
ION
SEPA
Planning
MAI 1 G AD RESS ,
��
Actual Set Backs in Feet to:
North South East West
4
COM
LICENSE EXPIRES
PHONE
Size of ParcelZone
Classification
Residential ❑
Fire
Prevent.
Commercial ❑
4.
O
ADDRESS
ZIP
Type Const. Occupancy
Sprinklered
v
W
Engineer
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
U.
Utilities
J. ADDRESS
ZIP
Main Floor Upper
Floors Garage/Storage
TOTAL $
Greenhouse
SEPA
MACHINE
HEIS BECOMES A PERM TTED IN THIS SPACE,
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
O
7 0 * O O 0
11 77 7_ s 2.
DATC-iSSUE PERMAZ z #OITAL
Building
Tech.%
TYPE
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
[�J-�EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 OF ❑OTHER
Certifi.ofExempt.
Required Yes❑ No❑
Number
WORK ❑ BLD. ❑ PLMB.,�ECH. ElM.H. ❑ POOL
or Variance
Received Yes❑ No❑
8 DESC BE WQfjl$ �b 0
r�
Shorelines/ Floodrd
�a� Required 0
/.
yes Not
Received ❑
VALUATION
I SOOUFCE
GAS
ELECTRIC
ER
PUBLIC ❑
EWAGE
SEPTIIC ❑
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
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 REVE SE SIDE FOR REGUIR D INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
[1WNFR np OC�FNT DATE
Mech.
SPECIAL
APPROVALS
PECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
O
Other (Specify)
v
W
Engineer
J_
U.
Utilities
TOTAL $
SEPA
MACHINE
HEIS BECOMES A PERM TTED IN THIS SPACE,
PERMIT IS NONTRANSFERABLE
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
O
7 0 * O O 0
11 77 7_ s 2.
DATC-iSSUE PERMAZ z #OITAL
Building
Tech.%