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1983, 01-28 Permit: 83A-684 WoodstoveNUMBER APPLICATION/PERMIT PERMIT NUMBER SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY r` -'� NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES STREET ADDRESS PARCEL NO. 2. Lo BLOCK SUBDIVISION LEGAL DESCnIPTION: Actual Set Backs in Feet to: North South East West Size of Parcel ZoneClassificationResidential ❑ Commercial ❑ Type Const. Occupancy Sprinklered ❑Yes ❑No ❑Req'd. New Const. Valuation Remodeled Valuation Total Bldg. Floor Area Main Floor Upper Floors i Garage/Storage Greenhouse Cover Deck Uncv. Deck Fin. Basement Unfin. Basemf OWNER No. Baths No. Floors No. Fin. Rooms PHONE PHONE 1:1 MVE. L> G Fes= (�, 7• OFD OTHER 3. I Certifi.ofExempt. Required YesC NoC Number MAILING ADDRESS r-5 6 P Received r I Pox G- DESC BE WO'RKShorelines/Flood Hazard CONTRACTOR� dL9f� C/ Yes ❑ Not Applic. ❑ LICENSE EXPIRES PHONE 4. GAS ELECTRIC PUBLIC IJ SEPTIC SEWAGEWATER Ownership FEES COLLECTED ADDRESS UTILITIES ZIP PRIVATE El DESIGNER Public LlPrivate ❑ PHONE 5. reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of ADDRESS work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- ZIP thority to violate or cancel the provisions of any other state CHANGE OF USE FROM TO 6. SIGNATURE OF APPLICATION — OWNER OR AGENT r Actual Set Backs in Feet to: North South East West Size of Parcel ZoneClassificationResidential ❑ Commercial ❑ Type Const. Occupancy Sprinklered ❑Yes ❑No ❑Req'd. New Const. Valuation Remodeled Valuation Total Bldg. Floor Area Main Floor Upper Floors i Garage/Storage Greenhouse Cover Deck Uncv. Deck Fin. Basement Unfin. Basemf :IAL CON PRELIM. FINAL DATE Env. Health Planning Prevent ilities (SEE REVERSE SIDE FOR NOTICE) Plans PERMIT IS NONTRANSFERABLE Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Buipng ( IN 180 DAYS L i Plan Check SEPA Modular/ MFG. Home Other (Specify) TOTAL $ WHEN MACHINE VALIDATED IN THIS SPACE, THIS oBElCOMES A PERMIT. DATE ISSUED 2 8 _ z PERMIT NO. *20.00° TOTAL CL C C LL LL No. Baths No. Floors No. Fin. Rooms No. Dwellings TYPE �f , NE�/�/ ❑ALT. 1:1 AD'N. ❑RPL. 1:1 MVE. 7• OFD OTHER Certifi.ofExempt. Required YesC NoC Number WORK 1:1BLD. ❑ PLMB_0 MECH. ElM.H. ElPOOL or Variance Received Yes ❑ Nor'. DESC BE WO'RKShorelines/Flood Hazard Plans Required 1-18• dL9f� C/ Yes ❑ Not Applic. ❑ Received ❑ VALUATION 9• I SO— OURCE GAS ELECTRIC PUBLIC IJ SEPTIC SEWAGEWATER Ownership FEES COLLECTED UTILITIES PRIVATE El SEWER ❑ Public LlPrivate ❑ 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 SIPE FORAE49CRED INSPECTIONS Plumbing SIGNATURE OF APPLICATION — OWNER OR AGENT r DATE f _ Mach. :IAL CON PRELIM. FINAL DATE Env. Health Planning Prevent ilities (SEE REVERSE SIDE FOR NOTICE) Plans PERMIT IS NONTRANSFERABLE Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Buipng ( IN 180 DAYS L i Plan Check SEPA Modular/ MFG. Home Other (Specify) TOTAL $ WHEN MACHINE VALIDATED IN THIS SPACE, THIS oBElCOMES A PERMIT. DATE ISSUED 2 8 _ z PERMIT NO. *20.00° TOTAL CL C C LL LL