HomeMy WebLinkAbout1980, 11-10 Permit: 80B-3544 Conversion BurnerPLAN 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
3 / 8 )Gr,+�//�j`//'��t r7/ y
1.LOT BLOCK i11 5 UBDIVI ION
C-ci lel l,o/V
2.
LEGAL DESCRIPTION - SEE ATTACHED
3
OWNER
VC2AiA &I /and
PHONE
PARCEL NUMBER/S
ADDRESS
• 5/'Pint,
ZIP
Actual Set Backs in Feet
North ISouth
East 'West
4.
CONTRACTOR
zN1 i-tv3lTIKiG.
ADDRESS
NI 3005 Craw, IMF
PHONE
484-4078
Size of Parcel 1 Zone Classification
ZIP
gg2v7
Type Const.
Occupancy Sprinklered
❑Yes DNo 0 Req'd.
5.
DESIGNER
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors Garage Area
Storage
6.
CHANGE OF USE FROM
O): 1
TO
/04 I IFerili \7Ft'rl
Area of Decks
Finished Basement
Unf in. Basement
TYPE
7. OF
WORK
❑ NEW
D.BLD.
0 ALT.
❑ PLMB.
❑ AD N.
0 MECH.
❑ RPL.
❑ M.H.
O MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. Of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. .r r -e, ada is mord sicn
VALUATION SOURCE GAS ELECTRIC WATER - SEWER
OF
9. VTI OF ES ✓
Enum. Dist.
Location (Area)
Ownership
Public 0 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 REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
/1-10-80
• SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Vtlliti es
Plans Examine
SEPA Check!'
Building
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
�Z� ns rpa��C /j'/100/4 Ad ain.5/'/ CI b pem t o yL,
a
W 25' o iii ,aLk
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
1412 Mech. ..00
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
8o'B^3Svct
04* *1200
* 1200
* 12.006
A. *000 3
35&32
11-10-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMESA PERMIT.
!11 O,,tka,pi 3151:44'= *12'OOa�
DATE ISSUED PERMIT NO. TOTAL
a
00
LL