HomeMy WebLinkAbout1983, 12-20 Permit 83B-2699 Wood StovePLAN NUMBER
1
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
1. _ /7/6 PAVN7
LOT
2. lcf
OWNER
3 DAVI D ALVX Niv PwP
BLOCK
4.
MAILING ADDRESS
S. ?7/6 DAV'Ip
CONTRACTOR
SUBDIVISION
V ALL yV (E4A) LULLS H RT
PHONE
3-.3g -312.1
LICENSE EXPIRES
PHONE
ZIPCrq 1
PHONE
PARCEL NO.
255. z- 031 `l
LEGAL DESCRIPTION:
Actual Set Backs In Feet to:
North (South [East I West
Zone Classification
Size of Parcel
Residential ❑
Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE ANEW
7. OF 0 BLD.
WORK
❑ ALT. 0 AD'N. ❑ RPL. 0 MVE.
❑ PLMB. VI-IGTECH. ❑ M.H. ❑ POOL
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes❑ No❑
Number
DESCRIBE WORK
8. UJ�v�p sn
VALUATION
9.
/N STM-LA-77W
SOOURCE
F
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Shorelines/Flood Hazard Plans Required ❑
Yes ID Not Apollo. 0 Received ❑
Ownership
Public 0 Private 0
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
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
SIGNATURE OF APPLICATIO
OWNER OR AGEN -� DATE 1 ?I
SPECIAL APPROVA S SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
2e$
TOTAL $
PERMIT NUMBER
Y31.3--2.Gri
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE#6JED2 u
3 PERMIT&. 7 z * 2 Oa U 0 fp'FAL