1979, 09-11 Permit: 79-3795 Fireplace, 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 4 COPIES
JOB ADDRESS
1. E 8204
LOT
2.
OWNER
,.�-�a+�/
3. ADDRESS
E .
32054
CONTRACTOR
SAME -4. AD
BLOCK
DESIGNER
CATAI-00 AUF.
LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISION
SCEDERS PPM 170N
PARCEL NUMBER/S /85//.2,
PHONE
q2 —3999
tA—rALPa AVE—, &Po/JANE—
ZIP
99206
Required Set/Backs in Feet
North E) 'South Ex East CX (West
PHONE
ZIP
PHONE
Size of Parcel 1 Zone Classification
Type Const.
Sprinklered
Ekes DNo 0 Req'd.
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
D W L Area
Basement Area 1 Garage Area
Storage
CHANGE OF USE FROM
6.
' TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑�,,
NEW 0 ALT. la -Co N. 0 RPL. 0 MVE.
SMECH:
19'BLD. ❑ PLMB. LJ 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
8.
DESCRIBE WORK
ADDITION OF c1tg4.N jl' l
VALUATIONITSource
9-4/000 00 Utilities
FiREPtAcC 1-0 E7115T7NG RgSiDENcE.-
GAS
LECTRIC
WATER
SEWER
EX1 s—r,ts19
I hereby certify that I have read and examined this applica ion 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.
DATE 9 -ii- 1 9 SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
OFFIC
APPROV
• FEES COLLECTED
Single $
Building deCie
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 31%
M
DATE 9-11-79
PERMIT NUMBER
71-3795
02* *17.00
*17.00 N
*17.006
6 *000 8
379.42
09-11-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THISCOME,A PERMIT
917:111=7' 3'79,55 *17.00°0
CC
1-
0uJ
0-
N