1982, 09-13 Permit: 82A-8161 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
JOB ADDRESS
N. 1110 CALVIN ROAD
LOT
BLOCK
2
SUBDIVISION
Veradale,Heights 5th Add. 924-6758
OWNER
3 HENRY C. SEIDLER
ADDRESS
Same
PHONE
work 922-2765
CONTRACTOR
4 Same
' ADDRESS
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
ZIP
99216
PHONE
ZIP
PHONE
ZIP
TO
AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
14542-9188
Actual Set Backs in Feet
North 'South
Size of Parcel
East West
Type Const.
Occupancy
Valuation
500.00
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Main Floor I Upper Floors Garage Area
Area of Decks
No. Baths
DESCRIBE WORK
8.
Masonry Chimne
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
Finished Basement
No. Stories
Storage
Unfin. Basement
No. Rooms
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
SEWER
Ownership
Public ❑ Private D
Req'd.
USE CODE
1 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 regul. i • onstr on or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS /
O +`- SIGNATURE OF APPLICANT a:WI- ,e( .
DATE OF APPLICATION
SPECIAL APPROVALS SPECI L CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building
•. 7 ?
nicia
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building 20.00
Plumbing
) Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 20.00
PERMIT NUMBER
?ZAt•jt(v
04* *20.00
*20.00
A *0:00
816OR
09-13-82
6479,
• WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
09-13-82 816.12
DATE ISSUED PERMIT NO
*2 0.0 01' -
TOTAL