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1982, 05-24 Permit: 82A-4087 Gas Piping
PLAN 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. JOB ADDRESS N •q- - 8651-• LEGAL DESCRIPTION - SEE ATTACHED 2. 3. LOT BLOCK SUBDIVISION COVTGR`ACTOR (c) 4. AD RES S (9 7 5. DESIGNER Z� .707f �tPa�6 PHONE ZI 1,2 t PHONE PARCEL NUMBER/S Actual Set Backs In Feet North 'South East 'West Size of Parcel 1 Zone Classification Type Const. Valuation Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. Building Area in Sq. Ft. ADDRESS ZIP Main Floor Upper Floors 1 Garage Area Storage CHANGE OF USE FROM 6. TO Area of Decks Finished Basement Unfin. Basement 7. TYPE OF WORK ❑ NEW ❑ BLD. DESCRIBE WOK 8. /S0/ ! 1 O ALT. O PLMB. 9. VALUATION SOURCE OF UTILITIES GAS ❑ AD'N. ❑ RPL. ❑ MVE. IRMECH. ❑ M.H. ❑ POOL 0 OTHER LECTRIC WATER SEWER No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Enum. Dist. Ownership Public ❑ Private ❑ Location (Area) USE CODE Req'd. 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 0.Y .3 SIGNATURE OF APPLICANT—t`Q SPECIAL APPROVALS NAAE DATE Env. Health Pianning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist syiwechnii4a4T7 SPECIAL CONDITIONS: p.ru.#g. .rx_k_shit4 /7S— ©oto PERMIT IS NONTRANSFERABLE Rec'd. Not Req'd. FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) 6 ccs TOTAL $ V rtMIT NUMBER �- 405 04* *19.00 * 19.00 * 1 9.00 A *0.00 8 08.6 05-24-82 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED 408,75 *19.00a17' PERMIT NO. IOTA •_