1983, 08-16 Permit: 83A-7874 Wood StovesPLAN NUMBER APPLICATION/PERMIT
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 PARCEL NO.
1. c . ila�"1 33~Zo
LOT sLOCI< I SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE /
3. MAILING ADDRESS ZIP Actual Set Backs in Feet to:
Ij
644,io -G.
North ISouth East I West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
VIAE
4. ADDRESS
ZIP
Type Const. Occupancy
Sprinklered
❑Yea ❑No ❑Req'd.
�� rvtE
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5. ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW ❑ ALT.
❑ RPL. ❑ MVE.7.
VOWN.
OF ❑OTHERWORK ❑ BLD. ❑ PLMB.ECH. ❑ M.H. ❑ POOL
CeVaiiExempt.
Required Yes❑ No ❑
Number
or
Received Yes❑ Nc❑
Shorelines/ Flood Hazard
Plans Required ❑
7p���RIBE W�O.g
8. � W� �TGvt'-��
yes Not Applic. ❑
Received ❑
VALUATION
SOURCE
GAS
ELECTRIC
WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
Ownership
1
FEES COLLECTED
9•
UTILLIITIES
PRIVATE ❑
SEWER ❑
public C1 Private ❑
I hereby certify that 1 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 SIDE FOR REOUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION g — j6f — ?,3
DATF `
Mach..
SPECIAL APPROVALS
PRELIM. FINAL D
Env. Health
Planning
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
PERMIT NUMBER
0-5A --1&
Other (Specify)
TOTAL $ =— --t
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECO11MES A PERMIT. 77 RR
DATEYSSUEDL 6 _ 8 3 PERMIT{N9. 7.4 * 3 0.0 0 40& -JAL