1980, 03-10 Permit: 80-1952 FireplacePLAN 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 4 COPIES
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK ISUBDIVISION I PARCEL NUMBER/S
n
ize of Parcel
OWNER
PHONE
3.
13',Ce CO2TIR--W
Sprinklered
94f6-6831
ADDRESS
aluation
ZIP
S QDz 11r,elfe,>
DWL Area
9WC6
Garage Area
CONTRACTOR
PHONE
4411 1'o
Split Entry
Split Level
4.
ADDRESS
ZIP
,5, of
No. Floors
9172163
Rec. Room
DESIGNER
PHONE
5.
CERTIFICATE
Req'd.
I Recd.
Not Rei
ADDRESS
ZIP
CHANGE OF USE FROM
TO
6.
TYPE if NEW ❑ ALT. ❑ AD -N. ❑ RPL.
❑ MVE.
7
1:1 BLD. ElPLMB. IrMECH: ElM.H.
❑ POOL ❑OTHER
WORK
DESCRIBE WORK
n
ize of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
I
Dyes ❑No ❑ Req'd.
aluation
Building Area in Sq. Ft.
DWL Area
Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
Req'd.
I Recd.
Not Rei
of EXEMPTION
FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities
Single $
1 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 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 regulating construction or the
Plumbing
performance of construction.
DATE 1,0 Z SIGNATUREL— ��
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
Checklist
Plan Check
SEPA
Mobile Home
Other (Specify)
7• ®O
PERMIT NUMBER
HI
DATE -,� - -90
TOTAL $ 7 DU
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE OFFICIAL CS Yr,' -- •' ,.
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