1981, 05-21 Permit: 81A-4969 Gas PipingNUMBER 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
327 _ � LEGAL DESCRIPTION —SEE ATTACHED
LOT I BLOCK [SUBDIVISION I PARCEL NUMBER/S
OWN R � V ` Vv� PHONE
Z
3.
ADD
rTSS # _ lJ 1 c � V Actual Set Backs in Feet
" :3 2--,-7`� — � 'V`� `� North South East
CONTRACT R
PHONE
Size of Parcel
Zone Classification
4' ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor I
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
TYPE❑
❑ NEW ❑ ALT.
AD -N.
❑ RPL. ❑ MVE.
7, OF
❑OTHER
❑ BLD. ❑ PLMB.
❑ MECH.
❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
II I
Enum. Dist.
Location (Area) FEES COLLECTED
8.
VALUATION I SOURCE GA LECTR C 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 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
DATE OF APPLICATION �.[ C 1 �l SIGNATURE OF APP LICAN T/IA/✓�%� Mech. —�SZ
SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
nC PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
P4A
no
496.8;"
i5 -G1-31
6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
05
;-'�`-g``l 4`9 69 Z
DATE ISSUED PERMIT NO.
TOTAL