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1982, 12-28 Permit M82B-2266 Wood StovePLAN NUMt3tR APPLICATION/PERMIT SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 STREET ADDRESS 1. LOT 2. APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES BLOCK I SUBDIVI jION 3. OWfyE�l I L MAI Le ADD co 4. ADDRESS E S LICENSE EXPIRES DESIGNER ADDRESS CHANGE OF USE FROM • PHONE 2-007 PHONE ZIP PHONE ZIP TO TYPE .IXNEW ❑ ALT. ❑ AD'N. 0 RPL. ❑ MVE. 7. OF ❑ OTHER WORK ❑ BLD. ❑ PLMB...EMECH. ❑ M.H. ❑ POOL 8. DESCRI E WO1R3j ©t�s✓ VALUATION 9. SOURCE UTILITIES GAS ELECTRIC WATER PUBLIC 0 PRIVATE ❑ SEWAGE SEPTIC ❑ SEWER ❑ PARCEL NO. LEGAL DESCRIPTION: Actual Set Backs In Feet to: North South Size of Parcel East West Zone Classification Type Const. Occupancy New Const. Valuation Residential 0 Commercial ❑ Sprinklered ❑Yes ❑No ❑Req'd. Remode ed Valuation Total Bldg. Floor Area Main Floor Upper Floors Over Deck No. Baths Certifi. of Exempt. or Variance Garage /Storage Uncv. Deck Fin. Basement Greenhouse Unfin. Basement No. Floors No. Fin. Rooms Shorelines/Flood Hazard Yes ID NotAppiic. ❑ Ownership Public 0 Private ❑ No. Dwellings Required Yes❑ No0 Number Received Yes Nor] 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 REOUIRED INSPECTIONS SIGNATURE OF /� APPLICATION OWNER OR AGENT r , 9-s,l DATE /. —7 —I-- 2, SPECIAL APPROVALS PRELIM. FINAL DATE Env. Health Planning Fire Prevent. 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 Plans Required ❑ Received ❑ FEES COLLECTED Building Plumbing Mech. Plan Check SEPA Modular/ MFG. Home Other (Specify) TOTAL $ 2 - PERMIT NUMBER 04* *2000 22659 12-28-82 g 6479. O LU —II U- WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATE]) Si a8-82 6 PERMII.U L d Z *20,00a°?AL