1983, 03-17 Permit: 83A-1963 ChimneyNUMBER 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
.? 0 � "1 LEGAL DESCRIPTION — SEE ATTACHED
LOT B O KUB I ISION ) PARCEL NUMBER/S
2. r� N �L d
3.
OW \! I R C �-'• t I �' ! Y PZ4 E' f
ATESS ^ .
AT
/1
CONTRA C 0 PHONE
4. ADDRESS ZIP
DESIGNER PHONE
5. ADDRESS ZIP
Actual Set Backs in Feet 1:7 `
TO
orth
South
East West
ize of Parcel
Zone C assification
ire Marshall
r
S NJ
Type Const.
Occupancy
prink ered
V7
No. of Dwellings
❑Yes ❑No ❑ Req'd.
'aluation
Building Area in Sq. Ft.
�
WORK G ""D. ElPLMB. ElMECH. ElM.H. 1:3 POO L
CERTIFICATE
Main Floor
I Upper Floors
Garage Area
I Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
ire Marshall
I
TYPE ❑ NEW Cl -'ALT. ❑ AWN. ❑ RPL. ❑ MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
7. OFEl OTHER
�
WORK G ""D. ElPLMB. ElMECH. ElM.H. 1:3 POO L
CERTIFICATE
Req'd.
I Recd.
Not R d.
of EXEMPTION
DESCRIBE WORK
�
Enum. Dist.
Location (Area)
FEES COLLECTED
8. HA60JAZ
, c
rte-
VALUATION,
SOURCE
GAS
EL CTRIC
WAT R
SEWER
Ownership
USE CODE
^�
9. /-Oo®
OF
OF
Public ❑ Private el
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 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/Plumbing
DATE OF APPLICATInN//' SIGNATIIRF nF APPI ICANT!C/�� G 1i
Mech.
SPECIAL APPROVALS
NAME DATE
nv.�Health
Nom"
Ew 0—
anning
ire Marshall
o. Fngineer
NO'
R� l�
SPECIAL CONDITIONS:
I
IIdi c h n i PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT PlUMB R
1036 ✓ ��
* 4 G, L Qu
n cf)
i Q/),_ c
( ?— 17_` 3
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
7 8A
:3r 1'96.3 z
DATE ISSUED PERMIT NO.
* 40.0.,0 a -�J- -
OTAL