1981, 03-13 Permit: 81A-2409 Gas Pipe Bunson BurnersLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
p_5)<
LOT
BLOCK
3.
OWNER
i
SUBDIVISION
•
ADDRESS
4.
CONTRACTOR ,
���, / i
_- & vC in 1 �` a7Lc � `f , ,c° t..- -,;
ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE
ZI P
PHONE
ZIP
PHONE
ZIP
TO
E NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
❑ OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
Required Set Backs in Feet
North
South East
Size of Parcel
Type Const.
Valuation
DWL Area
Split Entry
Occupancy
1Basement Area
West
Zone Classification
Sprinklered
❑Yes No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Split Level
Storage
Rancher
No. Baths
No. Floors
No. Rooms
Rec, Room
CERTI FICATE
of EXEMPTION
Req'd.
DESCRIBE WORK
V LLUATIJN
9.
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
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 authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. �f
DATE -1'/G" J V SIGNATURE i ) -LC
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
FOR GAS: ..
PIPE SIZES: /-�
PIPE LENGTHS: 5 C r
BTU'S: 6 CLOG
-
tsv ✓�+''.ir�r�;. _ iU -rip
DATE
r'—Yr
OFFICIA
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ f, r
1
PERMIT NUMBER
, yr
DATE
0q.* *1800
*1800 to-
*180.02
*0.00
24082
03 =13 -81
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THI BECOMES A PERMIT.
0 3;-
1,Y-8 1
240.9'Z *18.002I-
APPROVE ISSUANCE _
DATE REMARKS
n-D-21
RECORD OF INSPECTIONS
*
Final Inspection
INSPECTED BY
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR
N S E W
SET BACKS
TYPE OF WORK /
FINAL INSPECTION: pr. 0 —� /7
DATE
•
REMARKS:
y
`�''+ et_ Aerz.vuj .?M?�Y7 M.�� I vj241 I%NAlGL'
sEY, %� e-.47 u4t / ' I.4&(�Y l � S'1/4 it ceet, re) LC/! iZ
+. OWNER
111 a ADDRESS �•VA— LvK.o-iA Y /lam
N NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 011 JEFFERSON / SPOKANE, WASHINGTON 99360 / Ifio914560816
APPLICANT COMPLETE NUMBERED SPACES — PRESS BARD TO MAKE 4 COPIES
V JOB ADDRESS
1. LC1 ;;; 06SSb Vq eu '-
LN
2
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER'S
HON
.A".a 5.1
art hwnt
: AL. • v �.
•• AO ESE n ] _, .
Q
�• �eo L�Li;L
DoIDN
0.
JfNE
PV- 9a22,3
PHONE
co C•i
vU nonH I Occupancy
HH
wl
Oa ONP In Rap,
Bu ilal ne r.. nSq. Ft.
ADDR[f5
ZIP
CHAHO[ OP USE FRO
TO
TYPE ENEW 0 ALT, 0 AD'N. 0 RPL. 0 MVE,
%, r/ORH 0 ILO. 0 mans MEEK M.N. 0 POOL 0 OTHER
P Lava
ono
No ea.e. I NO. FINER I o, Room. I .c. Room
CERTIFICATE J Roc a. ryol R.g'd.
PI EXEMPTION
pISGRI[[WORN
a IV.- IASJII/uR_AnTI(�l.e.(ae
•
OAS ELECTRIC
WAT
SEWER
I hereby certlly that I Nee read and examined this apphcnuon and have read the "NOT:IiI icoNSIOTIS included
on muse stole, and knout the' seme to be true and correct. All provislonS of laws anll u,,ln,ences gov t Ing
type 111 5
pe of work will be complied with whether specified herein or not. The granting of a p,m� does not presunn
to give authority to violate or Cancel the provrsrons of a, other state or local law iwN. +tmg construction or the
performance of construction. ��//
DATE J- /D-sr / SIGNATURE 6t"-'1
Dm,
SPICIAL APPROVALS
R[O'D, R[e'O.
Inv, HN11R
Plans no
SPECIAL CCNDITIOntI Y yNs
FOR GAS; Rf4
PIPE SIZES: 17..
PIPE LENGTHS: 5.0
BTU'S: GJ coo RFlt
FEES COLLECTED
S'ngl. $
Building
Plumbing
Plan Ch.ok
BEPA
Mobil. Hem.
Other (Specify)
TOTAL $ 0'1
DATE
5, PERMIT NUMBER
3 A-- 2407
04• •1801
+1800
•180Dtf
•000
•4088
6479.
MIEN MACHINE VAI Mat rr, I'. I.IS sn Art
1