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1983, 11-14 Permit: 83B-1598 Wood Stove
PLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WASHINGTO499260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES STREETADDRESS PARCEL NO. 1. I;. 1 iZo'7 35 ;1j, LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION: 2. OWNER PHONE PHONE O©NALD JEFFKIE5 g_qF-5'1=7® 3. MAILING ADDRESS ZIP Actual Set Backs in Feet to: o7 — �. I 1 Z 3 5n4. p / 6 d ,Za North South East West CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential Commercial ❑ 4. ADDRESS ZIP Type Const. Occupancy Sprinklered ❑Yes ❑No ❑Req'd. DESIGNER PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area 5. ADDRESS ZIP Main Floor Upper Floors GaragelStorage 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. ❑ AD' N. ❑RPL. 1:1 MVE. C 7. OFElOTHER WORK ElBLD. ElPLMB. BCH. ❑ M.H. ❑ POOL Certifi.ofExempt.Required Yes❑ No❑ Number or Variance Received Yes❑ No❑ DE$CRIBE WORK Shorelines/ Flood Hazard Plans Required ❑ 8. WoOP 5 I oyf— Yes Not Applic. ❑ Received ❑ VALUATION I SOURCE OF GAS ELECTRIC I WATER PUBLIC ❑ SEWAGE SEPTIC ❑ Ownership FEES COLLECTED 9 UTILITIES PRIVATE ❑ SEWER ❑ public El 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 REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing SIGNATURE OF APPLICATION „ ttiok OWNER OR AGENT DATE Mech. �U SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE Env. Health Planning Prevent. Engineer Utilities Plans PERMIT IS NONTRANSFERABLE Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building IN 180 DAYS Tech. Plan Check SEPA Modular/ MFG. Home Other (Specify) TOTAL $ PERMIT NUMBER WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATEiUED— 9' 8 d PERMIT1O. *20,OO�AL