1981, 01-30 Permit: 81A-1043 Gas PipingPLAN NUMBER
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
OWNER •
DR SS
/ 7245 eztraider Ea
L✓.ct.('.ad --
CONTRACTOR
4.
ADDRESS
5.
DES
DE-SIGNER
PHONE
9 -35t/ -Z
ZIP
99D/!o
PHONE
. LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South East 'West
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Ves ❑No ❑ Req'd.
PHONE
Valuation Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE 0 NEW
7. OF
,WORK 0 BID.
O ALT.
O PLMB.
❑ AD N.
NI. MECH.
❑ RPL.
O M.H.
❑ MVE.
0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
p ESCRIBE N,',ORKa
8. 4eV P./10b1/1d
VALUATION soUROE
OF
UTILITIES
9.
GAS
liJi`.IYYLCC i
ELECTRIC 1 WATER
SEWER
En um. Dist.
Location (Area)
Ownership
Public El Private 0
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 j 'h'n ter?/ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Chec
Bu Id ng Te nicia
SPECIAL CONDITIONS:
..11-74}qug, v A 222 - - °K
0._g -9/
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
e.Mech.
��
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL fie? /s?
PERMIT.PYJ.MBE'-
$/A -/o¢3
04* *1200
* 1200
* 12006
A '* 0.0,0
10428
01 -3'0-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
;.1
QIl ;'31f 0'x-81
DATE ISSUED
1'0432 *120.0.21 -
PERMIT NO. TOTAL