1981, 10-22 Permit: 81B-990 ChimneyPLAN 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 3 COPIES
1.
2.
3.
4.
JOB ADDRESS
N. 5504 Bannen
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
John Bardelli
Pm_4003
PARCEL NUMBER /S
ADDRESS
N. 5504 Bannen, Spokane,
CONTRACTOR 11
Western Thermal Systems
ZI P
WA
Actual Set Backs in Feet
North (South
East
'West
PHONE
483 -1017
Size of Parcel 1 Zone Classification
ADDRESS
N. 2315 Division,
DESIGNER
5. ADDRESS
Spokane, WA
ZI P
99207
Type Const.
Occupancy
Sprinklered
❑Yes ENO ❑ Req'd.
PHONE
Valuation Building Area in Sq. Ft.
ZI P
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin, Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT. yy,❑ AD'N. ❑ RPL. ❑ MVE.
❑ PLMB, "1�3 MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
$• Install 6" Metalbestos chimney
CERTIFICATE
of EXEMPTION
Enum, Dist. I Location (Area)
Req'd.
Rec'd.
Not Req'd.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private ❑
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
,/ /%/ /zr(
SIGNATURE OF APPLICANT C� Lt�
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech. LPL_
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ /!
f1
PERMIT NUMBER
04* *17.00
* 1700
* 17.006
A *0.00 8
989
1 0-22 -81
z 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10 =2'2 X81;
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
PERMIT N6.' O Z