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1981, 03-11 Permit: 81A-2285 Gas PipingPLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPO}:ANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES 1. 2. 3. JOB A LOT (1,3712—:— SUBDIVISION LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S c % vJ c ; .. c �so,Q 4.. ` ADDR SS �� — "' /� �i.ye_ COf.TRA TOR 4. Pe5S G, 4/65- 3 0, 5. DESIGNER ADDRESS PHONE Z),, 24}6 PHON p �/ s7�[IXJ Actual Set Backs in Feet North 'South Size of Parcel Zone Classification East West zl8—�..2 Z PHONE Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. Valuation (Building Area in Sq. Ft. ZIP Main Floor Upper Floors 6. CHANGE OF USE FROM TO Area of Decks Garage Area Finished Basement Storage Unfin. Basement TYPE 7. OF WORK ❑ NEW O BLD. O ALT. O PLMB. 0 AD'N. E-"MECH. O RPL. ❑ M.H. ❑ MVE. 0 POOL SCRIBE WO K 8. VALUATION 9 • I hereby certify that 1 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 INSPECTS S - x.13+,0)' 13+iiti) c )2$)E bt SOURCE OF UTILITIES G!i ELECT R IC ❑ OTHER 6/ No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Enum. Dist. I Location (Area) Req'd. Rec'd. Not Req'd. WATE 1 SEWER Ownership Public ❑ Private ❑ USE CODE DATE OF A,FLICATI ON z -i / - 1 / SIGNATURE OF APPLICANT SPECIAL APPROVALS SPECIAL CONDITIONS: NAME DATE /403/d 40 _/., O i A i©A)M _ 6 R3 el !Ae,3 LaL -4(.1 Le) 1 -t -Th Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist Building T-chnician << PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single $ Building Plumbing Sk Z. , 00 Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ `l , O (.) PERMIT NUMBER S414'i�' 04* *12.00 * 12.00 * 1200'6 A *0.00 228.48 03-11-81 2 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 0 31-,1ai 81. 228.55 *1200a� DATE ISSUED PERMIT NO.