1983, 11-08 Permit: 83B-1423 Wood StovePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
b LEGAL DESCRIPTION - SEE ATTACHED ✓
LOT I BLOCK ISUBDIVISION PARCEL NUMBER/S
2. ►
OWNE �� I PHONE L i
3 •j
r
s. (_
AD R SS
VALUATION
ZIP
Actual Set Backs in Feet
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
North South
East West
CONTRACTOR
Public ❑ Private ❑
PHONE
Size of Parcel
Zone Classification
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION.S
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
Dyes ❑No ❑ Req'd.
DEStIGNER
SEPA
PHONE
Valuation
Building Area in Sq. Ft.
�- � ��---
i � �
(t1
� -
q, � 35
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished
Basement
Unfin. Basement
6.
Baths
No. Stories
No. Rooms
No. of Dwellings
TYPENo.
❑ NEW
ALT. ❑ AD'N.
❑ RPL.
❑ MVE.
7,
OF
❑ BLD.
❑ PLMB. ❑ MECH.
❑ M.H.
OTHER
❑ POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORP�
Enum. Dist. Location (Area)
FEES COLLECTED
s. (_
C v
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
I UTI O TIES
Public ❑ Private ❑
Single $
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
Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION.S
Plumbing
Mech.
DATE OF APPLICATION
SIGNATURE OF APPLICA
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Mobile Home
Other (Specify) ��yy���
TOTAL $
PERMIT NUMBER
v -I q,275
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
s
1140 g _43 14'2,3
DATE ISSUED PERMIT NO.
*20.00°�-
TOTAL