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1983, 11-28 Permit: 83B-2015 Masonry Chimney
PLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES STREET ADDRESS PARCEL NO. LOT BLOCK I SUBDIVISION I LEGAL DESCRIPTION: 2. OWNER PHONE PHONE 27 3. M ILINGADDRESS .tom +/ Zplp ActualSet Backs inFeet to: I1 114- !ca 10� Fes / %2 I � North I South I East West DESCJ31BEWOFkK 8• CO[J?J[iQCT� z:: -} LICENSE EXPIRES 'PHONE I Size of Parcel VALUATION SOURCE GAS ELECTRIC WATPUBLIC ❑ SEPTIC SEWAGER I Ownership 9 zone Classification Residential ❑ �)' reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of Building work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- thority to violate or cancel the provisions of any other state or local law regulating construction or the performance Commercial El 4. Plumbing SIGNATURE OFAPPLICATION U� OWNER OR AGENT e --<DATE / D U Mach. SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE Plan Check ADDRESS ZIP Type Const. Occupancy Sprinklered Modular/ MFG. Home Fire ❑Yes ❑No ❑Req'd. DESIGNER Other (Specify) PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area 5. WHEN MACHINE VALIDAT Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT. Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building I N 180 DAYS TechDATE ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement 6. No. Baths No. Floors No. Fin. Rooms No. Dwellings TYPE W NNE ❑ALT. ❑ AD'N. ❑RPL. El MVE. 7• OF 1-1 OTHER `S BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi. of Exempt. Required Yes❑ No❑ Number WORK or Variance Received Yes❑ No❑ DESCJ31BEWOFkK 8• & z:: -} * -r> Shorelines/ Flood Hazard Yes❑ Not Applic. ❑ Plans Required ❑ Received ❑ VALUATION SOURCE GAS ELECTRIC WATPUBLIC ❑ SEPTIC SEWAGER I Ownership 9 FEES COLLECTED UTILITIES PRIVATE ❑ SEWER ❑ Public ❑ Private ❑ 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 Building work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- thority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. SEE REVME SIDE FOR REOUIfWD INSPECTIONS Plumbing SIGNATURE OFAPPLICATION U� OWNER OR AGENT e --<DATE / D U Mach. SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE Plan Check Env. Health SEPA Planning Modular/ MFG. Home Fire Prevent. Engineer Other (Specify) Utilities s� ) Lsk TOTAL $ SEPA WHEN MACHINE VALIDAT Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT. Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building I N 180 DAYS TechDATE j UE ISS� — PERMIT NUMBER �3 ©I PERM 6. L 5 z * 2 u. 0 0 to&- AL L ri PERM 6. L 5 z * 2 u. 0 0 to&- AL L