1981, 01-06 Permit: 81A-57 Chimney(PLAN NUMBER
/
/6/2/
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
t, APPLICANT: COMPLETE NUMBERED SPACES = PRESS HARD TO MAKE 3 -COPIES
JOB ADDRESS
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LOT. �!��eiBtItS>Olk61A1
LEGAL DESCRIPTION — SEE ATTACHED
OIZcHfrkt/O AVG- \OOI'rlvfJ
2.
OWN R I5 A ICNI
rcV
ADDRESS
- 7I Ph(IA\I
CONTRACTO ,t- fi{l
4. -/1'7�//�✓ f �jA /
ADDRESS
6 C
iT
i C. / y
4%_ /41
DESIGNER
5.
HO
�NE2 -2070
PCC//��
HON✓
PARCEL NUMBER/S z r ^
tN. 751 of 6 . 150' g
13t,0 es 157
7 o c7 j Cr'nil
N . 150' or
Actual Set Backs in Feet
North 'South East
'West
Size of Parcel
Zone Classification
ZIP
PHONE
Tip?. Const.
Valuat on
Occupancy
Sprinklered
DYes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
L� N W 0 ALT. 0 AD'N. 0 RPL.
D. 0 PLMB. 0 MECH. 0 M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
R eq'd.
Rec'd.
Notyercl.
8.
DESCRIBE WORK y�.,�
I✓fr Gji- l tci I I�j Ni I
ELECTRIC
9.
VALUATION
3-7�i
SOURCE
OF
UTILITIES
GAS
Enum. Dist. I Location (Area)
I '
WATER
SEWER
Ownership' ,/
Public 0 Private {Q
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 / o 'g/ SIGNATURE OF APPLICANT' f t -&k51 6.a"/Lk— "`ttu
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Planning
Fire Marshall
Co. Enginee
" Utilities
Plans Examiner
PERMIT IS NONTRANSFERABLE
.PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
•
�o
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
g/A - s7
02* *1-Q00
*'10.00
*10.006
A *000 8
562
01 —064'8:1
• 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0i1b'8P6418.
DATE ISSUED
41 2
PERMIT NO.
*1 WO a-12
TOTAL