1985, 04-29 Permit 84A-1812 Basement Wood StovePLAN 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
LOT
2.
Ag13
BLOCK
SUBDIVISION
OWNER
3.
MAILING ADDRESS ZIP z f :,
PHONE
CONTRACTOR
4. ADDRESS
LICENSE EXPIRES
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
PHONE
ZIP
PHONE
TO
TYPE ❑ NEW )ALT. ❑ AD'N. 0 RPL. y.MVE.
7 OF WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ElPOOL El OTHER
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs In Feet to:
North
Size of Parcel
South
Type Const. Occupancy
East
West
Zone Classification
Residential 0
Commercial 0
Spr'nklered
❑Yes ❑No ❑Req'd.
New Const. Valuation
Main Floor
Cover Deck
No. Baths
Remode ed Valuation
Upper Floors
Uncv. Deck
No. Floors
Garage/Storage
Certifi. of Exempt.
or Variance
Fin. Basement
Total Bldg. Floor Area
Greenhouse
No. Fln. Rooms
Required Yes❑ No❑
Received Yes Nof]
Unfin. Basement
No. Dwellings
Number
DESCRIBE WORK
8.
VALUATION
9.
WOOt2 r(10 ro 134.6.Y)
SOURCE
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Shorelines/ Flood Hazard
Yes Not Applic. ❑
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 REVER8t`$1IDE FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION
DATE _.1,474___49
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required 0
Received 0
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $`
PERMIT NUMBER
f344— /S/2-
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DAT nSiUE D 2 — 8 4
PERMITINS. 1. 2 z *2 O. 0 0 I[Qi'AL