1981, 01-19 Permit: 81A-0606 FireplacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 956-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 -COPIES
1.
2.
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S,
3.
4.
5.
OWNER/C/c %% //)J /$�'/,(jam"%
ADD'/ / ;� f^�'✓ l.'
CONTRA
ADORES
EFE99.1)
ZIP.,-_ _
Actual Set Backs in Feet
North 'South
East
•
(West
PHONE
ZIP
PHONE
ZIP
Size of Parcel
Type Const.
Valuation
Main Floor
Occupancy
Upper Floors
Zone Classification
Sprinklered
Dyes' DNo D Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
�EW
0 BLD.
TO
Area of Decks
Finished Basement
Unf in. Basement
0 ALT. ❑ AA9 N. 0 RPL. ❑ MVE.
0 PLMB. IIO MECH. 0 M.H. 0 POOL
N OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WO.eK
8. Installation of Free Standing F lace
VALUATION' SOUOF
RCE
g, IiJTILITIES
Fire
GAS
ELECTRIC 1 WATER
Enum. Dist.
Location (Area)
SEWER
Ownership
Public ❑ Private 0
USE CODE
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 REVERSESIDEFOR REQUIRED INSPECTIONS/N��/y/'7/J �%�/1 �_/.�./
•
DATE OF APPLICATIONVbflhJA'WW/ �6,�/ a� SIGNATURE OF APPLICANT/ d / �� .Chn��• !d/.Gf=CJJ%
SPECIAL APPROGALS SPECIAL CONDITIONS:
Env. Health
Planning
Fire Marshall
NAME DATE
Unlit les
Plans Examine
SEPA
PERMIT IS NONTRANSFERABLE •
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing �7
Mech. I / f 00
Plan Check
SEPA
Mobile Horne
Other (Specify 1f ��
TOTAL
/i
PERMIT NUMBER
- o &06
04* *17.00
*17.00 tri.
*17.006
A *000 E
6051
0'1x19-81
.S4 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
:,0;1 i i .gli a,8 f11
DATE ISSUED
6'0. 64 *'1'R 0 0,11,0
PERMIT NO. TOTAL
U—