1982, 02-08 Permit: 82A-879 FireplaceEm"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
LEGAL DESCRIPTION — SEE ATTACHED
OT BLOIC7Kj.l0 PARCEL NUMBER/S
2.
OWNER PHONE
3.220411t LAA41;A4 22
ADDR S
ZIP
Actual Set Backs in Feet
r
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4'
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
r
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
s.
TYPE El NeW El ALT. 1771 AWN. El RPL. E] MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
7 OTHER
WORK 1:1 BLD. ❑ PLMB. ❑ MECH. ❑ M.H. El
CERTIFICATE
Req'd. I
Recd.
Not Req'd.
of EXEMPTION
DESCRIBE WOjVK
Enum. Dist.
Location (Area)
8.
FEES COLLECTED
ALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
1UTILITIEOS
Public ❑Private ❑
Single $
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
Building
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
Plumbing
'Zr q-82
Mech.
DATE OF APPLICATION
SIGNATURE OF APPLICANT `�
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
I
Plan Check
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
PERMIT IS NONTRANSFERABLE
�— PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
SEPA
Mobile Home
Other (Specify)
TOTAL $ • +M
PERMIT NUMBER
04* *20.00
*20,00
F7. '
0Z -v8 -8c
6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0;2'j08-8'2 87.92 *20.00 2. -0- -
DATE ISSUED PERMIT NO. TOTAL
C
C
C
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