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1981, 10-29 Permit: 81B-1273 Fireplace InsertPLAN NUMBER APPLICATION/ PERMIT ^� PERMIT NUMBER SPOKANE COUNTY — BUILDING CODES DEPARTMENT l' I 81 �- 12-7 3 / NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES JOB ADDRESS �. N. ` 09' H A N LEGAL DESCRIPTION - SEE ATTACHED LOT I BLOCK ISUBDIVISION PARCEL NUMBER/S OWNER PHONE 3.0 f --9: L . µ tit,' K i 5 c7 ? — 0`7 55 - ADDRESS ZIP Actual Set Backs in Feet 1 N `�0F JOHN � n� CM ZO(I North South East West CONTRACTOR PHONE Size of Parcel Zone Classification 4. ADDRESS ZIP Type Const. Occupancy Sprinklered -]Yes ❑No ❑ Req'd. DESIGNER PHONE Valuation Building Area in Sq. Ft. 5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement 6. TYPE 9-1qEW 1:1 ALT. El AD'N. El RPL. 1:1 MVE. No. Baths No. Stories No. Rooms No. of Dwellings 7. OF ❑ OTHER ❑ BLD. ❑ PLMB. CYMECH. ❑ M. H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd. WORK of EXEMPTION DESCRIBE WORK Enum. Dist. Location (Area) 8. wocP PI+2 Pilkc - INs�T FEES COL L ECTED VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE 9. OF UTILITIES Public ❑ Private ❑ Single $ 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 Building 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 7 DATE OF APPLICATION yL/ SIGNATURE OF APPLICAN Mech. XIV SPECIAL APPROVALS SPECIAL CONDITIONS: NAME DATE Env. Health Planning Co. Engineer Utilities ns Examiner Building Technician PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE Plan Check SEPA 04* *17,00 *17.00 * 1 7,000 A *a00 1 27.22 10-29-81 2 6,479. Mobile Home % S i✓t£ cn_ Other (Specify) O KK 6V TOTAL $ 7 WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. b ;=12 8 1 12' DATE ISSUED PERMIT NO. *17,90a► - TOTAL