1982, 09-16 Permit: 82A-8296 Masonry ChimneyAPPLIGATIUM/ PERMIT
F— - r• SPOKANE COUNTY — BUILDING CODES DEPARTMENT
ID / NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
v APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. S:3 i'�1• Ft.otz,r�, LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. sJ
JI? 0C)(o
ESQ i " Q l Id
OWNER
PHONE
qze,,2
3.
ADDRESS
ZIP
Actual Set Backs in Feet
1c
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North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
VWAA/Kc-
❑Yes []No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor I
Floors Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPE & No. Baths No. Stories No. Rooms No. of Dwellings
LTJ NEW ❑ALT. ❑ AD'N. ❑ RPL. I-] MVE.
7. OF 11 OTHER Req'd. Recd. Not Req'd.
WORK BLD. ❑ PLMB. 1-1MECH. ElM.H. ❑POOL CERTIFICATE
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area)
8• M' � Ci}41PylN FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
9. UTILOITIES 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 this2b.0a
Building
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 regulatin construction r the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS /�� Plumbing
rnnTE nE noni �nnT�� X11 .T//�' n�..n�,. T��r,�'.� ,. .,.,. .....�r 1 /t� //�/'1 Mech
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B g Te hnician PERMIT IS NONTRANSFERABLE
az"— A ---J PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ :2,0,�
YtKMI 1 IVUMtftK
02* *20.00
829.5 '
09-16-82
6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'.9�a.6 8'2 829,62
DATE ISSUED PERMIT NO.
*20.00a-�j
TOTAL
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