1982, 08-25 Permit: 82A-7471 ChimneyPLAN NUMBER
G
APPLICATION /PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
3.
4.
JOB ADDRESS
7/ , BL8Ck SUB IKII� 1
OWNED
ADDrjESS
ADDRESS
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHON E
PHONE
ZIP
PHONE
ZIP
TO
❑ NEW ❑ ALT. Q AD'N. ❑ RPL. ❑ MVE.
F11/BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
DESCRIBE WORK
8. ' ,: oK -t c I
VALUATION
9. 130
SOURCE GAS
OF
UTILITIES
ELECTRIC
WATER
SEWER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S `.,����
Actual Set Backs in Feet
North 'South
iize of Parcel
Typninst.
Valuation
Occupancy
J
Main Floor
Area of Decks
No. Baths
Upper Floors
East
West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
No, Stories
Storage
Unfin. Basement
No. Rooms
CERTIFICATE Req'd.
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private (
Location (Area)
USE CODE
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION .. - ' 2_ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
Rec'd.
No ' eq'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
0
PERMIT NUMBER
<-k j 7471
02* *2000
*20.006
A *0,00 8
747.02
08-25 -82
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0''8 5‘-'8 2. 7 4 7.15 *2 0.0 0 a -
DATE ISSUED
PERMIT NO. TOTAL