1981, 10-20 Permit: 81B-890 ChimneyPLAN NUMBER
•44r
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
JOBADDREI S
tit 4-\ ero J
T BLOCK SUBDIVISION I
Z CIARK St.)14, tslc,n
LO
ID
OVIthIER
Donald A Gri ese rncr
P O?'�2NE
�-O(a 70
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
ADDBESS
L_1311 1.4ec'0�I
zI99 o i
'Actual Set Backs in Feet
North 'South
East
(West
4.
CONTRACTOR
ADDRESS
As Ahvvg-
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
5.
DESIGNER
rryl-
PHONE
Valuation
Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors I Garage Area
Storage
6.
CHANGE OF USE FROM
-•--tee.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
O NEW
❑ BLD.
❑ ALT. ISAD'N. 0 RPL. 0 MVE.
❑ PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
CRIBE WORK
$ r nI .tmn�
VALUATION URCE GAS
OF
9. ton on UTILLITIES
Enum. Dist.
Location (Area)
ELECPRIC I - WPJTER I—SEWER
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
!Ownership
Public 0 Private 0
USE CODE
examined this application and have read the "NOTICE" provisions included
to be, true and correct. All provisions of d lawsordinances overning this
whether specified herein or not. The grantingting �f a perm d s not presume
the provisions of any other state or local la r gulatin co ruction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIOI
DATE OF APPLICI!TION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Ire Marshall
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building �Q %
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
a0
TOTAL $ /0 5tc
PERMIT NUMBER
818- 890
02*' *10.00
*10.00
8898
10-20-81
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1!i0;;?!2�0'"8;1; 8:9, 0 V *1 at) O Fi
DATE ISSUED PERMIT NO. TOTP