1982, 12-21 Permit: 82B-2119 Wood StovePLAN NUMBER APPL LCAT ION /PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY ' ";,
fl NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREET -ADDRESS PARCEL NO.
Lor BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER
HO A�
PHONE
3. to
MAILIUPADD ESS
G
Actual Set Backs in Feet to:
�)
North South East West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
�. �\ C C
4.
Commercial ❑
1 c
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
*
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
otal Bldg. Floor Area
P
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
-
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
TO—
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW El ALT. ❑ AD'N. El RPL. 11 MVE.
%
WORK ❑ BLD. ❑ PLMB.,Z'MECH. ElM.H. ElPOOL ❑OTHER
Certifi. of Exempt.
Required Yes❑ No[]
Number
or Variance
Received Yes❑ No❑
DESCRIB
8'
WORK�„
Shorelines/Flood Hazard
Plans Required El
C�
Yes❑ Not Applic. ❑
Received ❑
VALUATION
SOOUFCE
GAS
GAS
ELECTRIC
PUBLIC ❑
SEWAGE
SEPTIC El
FEES COLLECTED
9•
UWATER
TILITIES
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-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE ERS SIDE FOR REOUI D INSPECTIONS
Plumbing
SIGNATURE OFAPPLICATION
Z o _
OWNER OR AGENT DATE
Mach.
SPECIAL
APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
SEPA
Planning
Modular/
MFG. Home
>_
Fire
Prevent.
Other (Specify)
a.
ca
C3
Engineer
W
J_
LL
Utilities
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
11 1— 8 2 l 1, 9 z 2 0, 0.0 0 J
*
Iil
Building
Tech.
t
`
�
DATE' PERMI�O. %TAL