1984, 03-29 Permit: 84A-2715 Wood Stove, ChimneyPLAN NUMBER
ZIP
APPLICATION/PERMIT
Floors
Garage/Storage
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
- -�
CHANGE OF USE FROM
PARCEL NO.
�. 6- I�i�
Uncv. Deck
in. Basement
Unfin. BasemE
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
s No.
Floors
No. Fin. Rooms
OWNER
I Iii
TYPE NEW ❑ ALT. DAWN. ❑ RPL. ❑ MVE.
PHONE
PHONE
3.
7 /❑OTHER
MAILING ADDRESS
WORK ❑ BLD. ❑ PLMB.,OMECH. ❑ M.H. ❑ POOL
fExempt.
Required
Actual Set Backs in Feet to:
7
l ami !✓
n
North South East West
CONTRACTOR
DESC
8es❑
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential 114
GAS
ELECTRIC
PUBLIC ❑
SEPT CG❑
Ownership
1
1 Commercial El
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
1 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
Dyes ❑No ❑Req'd.
DESIGNER
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE, `Z
Mech.
SPECIAL APPROVALS
SPECIAL CONDI IONS: (SEE REVERSE SIDE FOR NOTICE)
ADDRESS
ZIP
or Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
eck
Uncv. Deck
in. Basement
Unfin. BasemE
6.
s No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW ❑ ALT. DAWN. ❑ RPL. ❑ MVE.
[No.
7 /❑OTHER
WORK ❑ BLD. ❑ PLMB.,OMECH. ❑ M.H. ❑ POOL
fExempt.
Required
Yes❑ No❑
Number
ce
Received
Yes❑ No❑
DESC
8es❑
IBEWORK i
orelines/Flood Hazard
Not Applic. ❑
Plans Required ❑
Received ❑
VALUATION
SODURCE
GAS
ELECTRIC
PUBLIC ❑
SEPT CG❑
Ownership
FEES COLLECTED
9
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑Private ❑
1 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 REVE SE SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE, `Z
Mech.
SPECIAL APPROVALS
SPECIAL CONDI IONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env.:-lealth
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Engineer
I
Other (Specify)
Utilities
TOTAL $ '30.
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE FERMI
Plans THIS BECOMES A PERMIT..
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
mg IN 180 DAYS �} 3 : 2
Gj DATE ISSUED
P�M NUMBER
}
2 7 1. 5 z
PERMIT NO.
*3C00°_�j
TOTAL