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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