1981, 10-23 Permit: 81B-1024 Fireplace0
PLAN NUMBER
1.
2.
3
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
'' i70
LOT BLOCK [SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER PHONE
7
ADDRESS ZIP Actual Set Backs in Feet
' / �' " 0,24\1
" 12.40
North (South lEast West
4.
CONTR
L•
ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE Size of Parcel 1 Zone Classification
ZIP
PHONE
ZIP
TO
LJ N▪ EW ❑ ALT. ❑ ic,k2 N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. (CH. ❑ M.H. ❑ POOL
❑ OTHER
DESCRIBE WORK
8. 01 I\
VALUATION SOURCE GAS LECTRIC WATER
9.
OF
UTILITIES
SEWER
Type,Const.
Valuation
Main Floor
Occupancy
Upper Floors
Area of Decks
No. Baths
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Storage
Unfin. Basement
No. Rooms
Req'd.
Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
I hereby certify that I have read and examined this application and have reaa 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 lawreg lating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 47.1 2� ` 9 SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing r--(7Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 1?
PERMIT NUMBER
04* *1700
* 17.00
* 17.006
A *000 ES
10232
10-23-81
6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1i:-2.34'4 Y 10 a 4 z *1 7. 0 0
DATE ISSUED PERMIT NO. TOTAL