1982, 11-24 Permit: 82B-1377 Fireplace InsertPLAN 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
JOB ADDRESS /� /Th
1. 5 . a �a / !9N L D U % f6? L ✓,d
LOT
2.
BLOCK
SUBDIVISION
OWNER
3.eR4 Z ,O Tl oPexn
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
ADDRESS //��
. -.? o 4" 96 A t- U 3.- .
CONTRACTOR
rE.�^
GrJ`SQ, j Z.0Eign)4L S91.57E277-5;
4. ApDRESS
DESIGNER
ZIP
9 y.1"1")o 1
PHONE
474-77—
5' ADDRESS
ZIP
PHONE
ZIP
Actual Set Backs in Feet
North (SouthEast (West
Zone Classification
Occupancy Sprinklered
❑Ves DNo O'Req'd.
Building Area in Sq. Ft.
Upper Floors Garage Area Storage
Size of Parcel
Type Const.
Valuation
Main Floor
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfln. Basement
TYPE 0 NEW
7. OF
WORK 0 BLD.
❑ ALT. 0AD N. 0 RPL. 0 MVE.
❑ PLMB. i M/ECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Reqs.
Rec'd.
Not Req'd.
DESCRIBE WORK
8:-0�`�1—Cil-t-'�-�-z.�
VALUATION SOURCE GAS
OF
UTILITIES
9. 9S-0
ELECTRIC
WATER
Enum. Dist.
Location (Area)
SEWER
Ownership
Public 0 Private 0
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 APPLICAPION f/";"?/59-2
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
SIGNATURE OF APPLIC
Env. Health
anning
Fire Marshall
Co. Engines
Utilities
Plans Examine
SEPA Checkl
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
gZ -1377
04* *2000
*2Q006
A *000
137.62
1'1 =24-82
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1'f1, 2'4' '8t'? 1 3 7.:7 0 * DATE ISSUED PERMIT NGl---